[The Amniotic Fluid Index Does Not Predict Adverse Pregnancy Outcomes among Women with Rupture of Membranes at Term]

Premature rupture of membranes (PROM) refers to the spontaneous rupture of membranes before the onset of labor. PROM, regardless of gestational age, is linked to increased risks of perinatal infections and umbilical cord compression. Amniotic fluid plays a crucial role in fetal development and growth, and its volume is essential for proper fetal well-being. Measurement of amniotic fluid volume (AFV) through prenatal ultrasound has become a standard practice in fetal monitoring. While numerous studies have explored the relationship between AFV and preterm PROM, few have focused on its association with term PROM. The aim of our study was to evaluate the relationship and predictive value of ultrasound-measured AFV in relation to adverse pregnancy outcomes.

This retrospective study included women with singleton pregnancies with PROM admitted to Meir Medical Center, a tertiary academic medical center. Term PROM was defined as occurring between 37+0 and 41+6 weeks of gestation. The study received approval from the Research Ethics Committee of Meir Medical Center (MMC-0125-24). The women were divided into two groups based on their amniotic fluid index: normal AFV (≥5 cm) and oligohydramnios (<5 cm).

A total of 537 women were admitted with PROM during the study period, and 402 met the inclusion criteria. Among them, 319 (79.4%) had normal AFV, and 83 (20.6%) had oligohydramnios. No significant differences were found between the two groups regarding maternal outcomes (postpartum hemorrhage, amnionitis, meconium-stained fluid, or placental abruption() or neonatal outcomes (respiratory distress, fetal sepsis, or neonatal intensive care unit (NICU) admission).

Women presenting with PROM and oligohydramnios can be reassured, as no association was found between AFV at the time of presentation and adverse pregnancy outcomes. Further research is needed to deepen our understanding of the relationship between amniotic fluid volume and membrane rupture at term.