An amniotic fluid index of less than 5 cm indicates?

Daman & Diu Staff Nurse - 2018

Obstetrics & Gynaecology

Easy

Appeared in: Daman & Diu Staff Nurse - 2018

Explanation

The Amniotic Fluid Index (AFI) is a quantitative ultrasound measurement used to estimate the volume of amniotic fluid.
A value of less than 5 cm is the standard diagnostic criterion for Oligohydramnios, which signifies an abnormally low level of amniotic fluid.
Oligohydramnios is a significant finding as it can be associated with underlying maternal or fetal conditions and increases the risk of complications like umbilical cord compression.
Fetal urine production is the primary source of amniotic fluid in the second half of pregnancy, so low fluid can indicate issues with the fetal kidneys or uteroplacental insufficiency.

Option A: Anhydramnios refers to the complete absence of amniotic fluid, which is a more severe condition than simply having a low volume. An AFI of less than 5 cm indicates low fluid, not a total lack of it.
Option B: Hydramnios is the opposite of oligohydramnios. It signifies an excessive amount of amniotic fluid.
Option C: Polyhydramnios is a synonym for hydramnios, meaning there is too much amniotic fluid, not too little. The question describes a low fluid index.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Interpretation of Amniotic Fluid Index (AFI) values in pregnancy as background academic context rather than a clinical decision trigger.
Nurses play a key role in recognizing the significance of AFI results and initiating appropriate fetal surveillance. Oligohydramnios requires close monitoring for signs of fetal distress, such as changes in the fetal heart rate, due to the increased risk of umbilical cord compression.
Patient education is crucial. The nurse must explain the condition to the expectant mother, the need for increased monitoring (like non-stress tests or biophysical profiles), and signs to watch for, such as decreased fetal movement.
What if? If the AFI was 26 cm instead of less than 5 cm, the diagnosis would be Polyhydramnios. The clinical focus would shift from cord compression risk to risks associated with uterine overdistension, such as preterm labor, premature rupture of membranes, and postpartum hemorrhage.

How to Approach the Question

First, identify the key clinical value provided in the question: "Amniotic fluid index of less than 5 cm."
Next, recall or look up the definitions for the terms related to amniotic fluid volume provided in the options.
Match the given AFI value (< 5 cm) to its corresponding medical term.
Anhydramnios means no fluid.
Hydramnios and Polyhydramnios mean too much fluid (> 24 cm).
Oligohydramnios means too little fluid (< 5 cm).

Concept Tested & Keywords

Concept Tested: Interpretation of Amniotic Fluid Index (AFI) values in pregnancy.
Stem keywords: amniotic fluid index, AFI, less than 5 cm
Lead-in keywords: indicates

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E6 Obstetrics Williams p. 54-72

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 56-70