Amniotic fluid index measurement with the four-quadrant technique during pregnancy

Eleven hundred thirty-four pregnant women with reliable dates underwent ultrasound evaluation for amniotic fluid index (AFI) measurement with the modified four-quadrant technique. We found that from 13 weeks' gestation the AFI rose progressively until 26 weeks. From then to 38 weeks the AFI measurements demonstrated little variation. After 38 weeks the AFI appeared to decline gradually. In the third trimester the mean AFI was 16.0 +/- 4.8 cm; 5% of cases had an AFI less than or equal to 8 cm, and 5% had an AFI greater than or equal to 24 cm. These results confirm the reproducibility of the semiquantitative technique and suggest that in estimating amniotic fluid volume, AFI measurement may be a more appropriate means than measurement of the single largest pocket or subjective assessment. Serial AFI measurement would be an effective way of assessing fetal status throughout pregnancy.