What does an amniotic fluid index (AFI) of 28 cm indicate?

An amniotic fluid index (AFI) of 28 cm indicates hydramnios, more specifically polyhydramnios, which is an excess of amniotic fluid surrounding the fetus. The normal range for AFI is typically between 8 to 18 cm, and values above 18 cm suggest some degree of polyhydramnios. When the AFI reaches 28 cm, it confirms significant overproduction of amniotic fluid.

Polyhydramnios can be associated with various maternal and fetal conditions, such as gestational diabetes, multiple gestations, and fetal anomalies that may affect swallowing or absorption of amniotic fluid. Monitoring and further evaluation may be necessary, given that increased amniotic fluid can lead to complications such as preterm labor, placental abruption, and increased risk for cesarean delivery.

In contrast, lower AFI values would indicate oligohydramnios, which is a deficiency of amniotic fluid, and does not suggest normal fluid levels or the immediate need for surgical intervention like a cesarean section. Therefore, 28 cm is clearly indicative of polyhydramnios, affirming the choice made.