On ultrasound assessment of amniotic fluid volume, the deepest vertical pockets measured in the four quadrants are 1.5 cm, 0.8 cm, 1.2 cm and 1.0 cm. This finding suggests which of the following?

1. A

   Oligohydramnios

2. B

   Polyhydramnios

3. C

   Borderline oligohydramnios

4. D

   Normal amniotic fluid volume

Appeared in: NORCET-11 Prelims

Explanation

• AFI is calculated by summing the deepest vertical pockets in each quadrant.
• An AFI less than 5 cm is diagnostic for oligohydramnios.
• Oligohydramnios is associated with increased perinatal risks and requires close monitoring.

Why Other Options Were Wrong

• Option B: Polyhydramnios is defined as an AFI greater than 24 or 25 cm, or a single deepest pocket greater than 8 cm. The given AFI of 4.5 cm is far below this threshold.
• Option C: Borderline oligohydramnios refers to an AFI between 5 and 8 cm. The calculated AFI of 4.5 cm is below this range.
• Option D: Normal amniotic fluid volume is defined as an AFI between 8 and 24/25 cm. The value of 4.5 cm is well below the normal range.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Interpretation of Amniotic Fluid Index (AFI) and diagnosis of oligohydramnios to guide bedside assessment, documentation, and the next nursing action.
• Nurses must recognize oligohydramnios as it increases the risk for fetal distress, growth restriction, and adverse perinatal outcomes.
• Prompt identification allows for closer fetal surveillance and timely intervention, such as delivery if indicated.
• What if? If the AFI was 6.5 cm, the diagnosis would be borderline oligohydramnios, and management might be more conservative with increased monitoring rather than immediate intervention.

How to Approach the Question

• Carefully sum the four quadrant measurements to calculate the AFI.
• Recall the diagnostic cutoffs for oligohydramnios, borderline, normal, and polyhydramnios.
• Match the calculated AFI to the correct diagnostic category.
• Eliminate options that do not fit the AFI value.
• Use the AFI thresholds as your key decision point for selecting the answer.

Concept Tested & Keywords

• Concept Tested: Interpretation of Amniotic Fluid Index (AFI) and diagnosis of oligohydramnios
• Stem keywords: ultrasound assessment, amniotic fluid volume, deepest vertical pockets, four quadrants, AFI
• Lead-in keywords: finding suggests, diagnosis
• Clinical cues: AFI sum is 4.5 cm
• Clinical cues: thresholds for oligohydramnios

Question ID

QsmGcmq6zpaehCuAXYLerB

Copy ID

Reference Book

E6 Obstetrics Williams p. 54-72