Reena Sethia was 34 weeks pregnant when she came in for a routine check up.She had just found out that her amniotic fluid index (AFI) was lower than 5. Concerned, she asked “How much AFI is required for a normal delivery?”
Dr. Priti Arora Dhamija, Senior Obstetrician-Gynecologist at Sitaram Bhartia in South Delhi sat her down and explained the concept of amniotic fluid index. , “During pregnancy, the foetus thrives in an ‘amniotic sac’ in the mother’s womb. The sac is filled with a fluid, called amniotic fluid, which plays a role in the baby’s development. “
“Toward the last few months of pregnancy, it is normal for the amniotic fluid to decline. “
At times, ultrasounds in the third trimester may detect low AFI levels.
“When the amniotic fluid index is less than 5 cms, the condition is called Oligohydramnios.”
“First-time mothers often panic in case of low amniotic fluid index but this condition can be managed, “ asserted the doctor.
“Your condition will have to be monitored closely to assess the baby’s growth and development.”
Reena began to feel hopeful about having a normal birth. She then asked about the ideal amniotic fluid levels in the (third trimester).
“How much AFI is required for a normal delivery?”
“There is no specific AFI level for a normal delivery. “
“Usually amniotic fluid index ranges between 5 to 25 cm.”
“A lower AFI level does not necessarily indicate the need for a cesarean as long as your baby is growing well. “
If during labour, there are signs of high fetal distress, a cesarean may be recommended.
“How much should AFI be at 34 weeks?”
“Normal amniotic fluid index ranges from 880ml to 1 litre at around 34 weeks. There’s a regular shift in the levels of amniotic fluid index (AFI) throughout your pregnancy but as soon as you enter your third trimester, the fluctuations in the AFI level increases.” explains the doctor.
Intrigued by the variation in levels in each week, Reena wanted to learn about the calculation of the amniotic fluid index.
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“How is AFI calculated?”
There are two major yet indirect ways of amniotic fluid index calculation, used by a sonographer to assess the AFI level, mostly during the third trimester of your pregnancy.
MVP (Maximum vertical pocket) is the more predective method in comparison to AFI (Amniotic fluid index).
Reassured that there was no specific answer to her question about how much afi is required for normal delivery, she sought to understand how to increase amniotic fluid.
How to increase AFI in pregnancy
How to increase amniotic fluid depends on your condition, and may not be the same for every woman who has low amniotic fluid.
Some simple measures to take include
- Drinking 10-12 glasses of fluid a day, which may help increase amniotic fluid levels
- Sleeping for atleast 8 hours a day, which also helps improve blood circulation
- Being in touch and regularly following up with your gynecologist
“Don’t hesitate to get a second opinion if you feel you need one. “
Reena made it a point to visit her gynecologist as advised, drink more water, coconut water and lemonade and rest enough to achieve almost normal afi levels at 37 weeks. With an amniotic fluid index of 6, she was able to have the normal birth she wanted.
This blog post has been written with editorial inputs from senior gnecologists at Sitaram Bhartia Institute of Science and Research.
Medically Reviewed by Dr. Priti Arora Dhamija
MBBS, Maulana Azad Medical College, Delhi (1999); M.D, Lady Hardinge Medical College (2004); DNB Obstetrics & Gynecology (2004); Diploma in Pelvic Endoscopy, Kiel, Germany (2014)
Experience: 17 years