Document Detail


Amniotic fluid and the clinical relevance of the sonographically estimated amniotic fluid volume: oligohydramnios.
MedLine Citation:
PMID:  22039031     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The amniotic fluid volume (AFV) is regulated by several systems, including the in-tramembranous pathway, fetal production (fetal urine and lung fluid) and uptake (fetal swallowing), and the balance of fluid movement via osmotic gradients. The normal AFV across gestation has not been clearly defined; consequently, abnormal volumes are also poorly defined. Actual AFVs can be measured by dye dilution techniques and directly measured at cesarean delivery; however, these techniques are time-consuming, are invasive, and require laboratory support, and direct measurement can only be done at cesarean delivery. As a result of these limitations, the AFV is estimated by the amniotic fluid index (AFI), the single deepest pocket, and subjective assessment of the AFV. Unfortunately, sonographic estimates of the AFV correlate poorly with dye-determined or directly measured amniotic fluid. The recent use of color Doppler sonography has not improved the diagnostic accuracy of sonographic estimates of the AFV but instead has led to overdiagnosis of oligohydramnios. The relationship between the fixed cutoffs of an AFI of 5 cm or less and a single deepest pocket of 2 cm or less for identifying adverse pregnancy outcomes is uncertain. The use of the single deepest pocket compared to the AFI to identify oligohydramnios in at-risk pregnancies seems to be a better choice because the use of the AFI leads to an increase in the diagnosis of oligohydramnios, resulting in more labor inductions and cesarean deliveries without any improvement in peripartum outcomes.
Authors:
Everett F Magann; Adam T Sandlin; Songthip T Ounpraseuth
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  30     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-31     Completed Date:  2012-02-24     Revised Date:  2012-04-30    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1573-85     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, AR 72205 USA. efmagann@uams.edu
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MeSH Terms
Descriptor/Qualifier:
Amniotic Fluid / chemistry,  ultrasonography*
Deglutition / physiology
Dye Dilution Technique
Female
Humans
Lung / embryology
Oligohydramnios / ultrasonography
Osmolar Concentration
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Ultrasonography, Prenatal*
Urination / physiology
Comments/Corrections
Comment In:
J Ultrasound Med. 2012 Apr;31(4):666; author reply 666   [PMID:  22441929 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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