Mrcog Part 3 You Can Do It

2026 last update on OHSS GREENTOP GUIDELINE .5

DR FATMA ALAZRAQ
RCOG MEMPERSHIP.

Amniotic Fluid Index (AFI)

What is AFI?
• AFI = total amniotic fluid measured by ultrasound in 4 uterine quadrants (UR, UL, LR, LL).

How to measure?
• Measure the deepest vertical pocket in each quadrant
• Add all 4 values = AFI

AFI Values

✅ Normal: 6–24 cm
• Median 8–18 cm (weeks 20–35), then decreases

⚠️ Oligohydramnios: ≤5 cm
⚠️ Polyhydramnios: ≥25 cm

Oligohydramnios
• Most common cause: ruptured membranes (PROM)
• Can be linked to uteroplacental insufficiency
• Often associated with IUGR (~60%)
• Check for GU malformations / fetal anomalies

Polyhydramnios

Causes:
• Fetal malformations (anencephaly, esophageal/intestinal atresia)
• Genetic disorders
• Maternal diabetes
• Multiple gestation
• Fetal anemia
• Viral infections

Complications (uterine overdistention →):
• Preterm labor
• PROM
• Fetal malposition
• Uterine atony

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