Document Detail


Antenatal testing among 1001 patients at high risk: the role of ultrasonographic estimate of amniotic fluid volume.
MedLine Citation:
PMID:  10368467     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Our goal was to compare the accuracy of the amniotic fluid index and the 2-diameter pocket technique with respect to accuracy in predicting an adverse pregnancy outcome among patients at high risk undergoing antenatal testing. STUDY DESIGN: All women with high-risk pregnancies and intact membranes who underwent antenatal testing during an 18-month period were prospectively enrolled. Ultrasonographic estimates of amniotic fluid volume were performed by means of the amniotic fluid index and the 2-diameter pocket technique. Relative risks with 95% confidence intervals and receiver operator characteristic curves were calculated for patients with an ultrasonographic estimate of oligohydramnios (amniotic fluid index of </=5 cm or 2-diameter pocket of </=15 cm2) versus normal fluid level (amniotic fluid index of >5 cm or 2-diameter pocket of >15 cm2). Outcome variables studied were intrapartum and neonatal complications. RESULTS: Among 1001 patients the mean (+/-SD) amniotic fluid index was 10.5 +/- 5 cm and the mean (+/-SD) 2-diameter pocket was 18.7 +/- 13.6 cm2. Significantly more patients (46%) were considered to have oligohydramnios according to the 2-diameter pocket criteria than according to the amniotic fluid index (21%, P <.0001, relative risk 1.7, 95% confidence interval 1.5-1.8). No significant differences in the incidences of nonreactive nonstress test results, meconium-stained amniotic fluid, cesarean delivery for fetal distress, low Apgar scores, or infants with cord pH of <7.10 were observed between the oligohydramnios and normal amniotic fluid groups (P >.05) when assessed by relative risk with confidence interval and by receiver operator characteristic curves. CONCLUSIONS: Current ultrasonographic measurements with the amniotic fluid index and the 2-diameter pocket technique are poor diagnostic tests to determine whether a patient is at high risk for an adverse perinatal outcome.
Authors:
E F Magann; S P Chauhan; M J Kinsella; M F McNamara; N S Whitworth; J C Morrison
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  180     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-07-15     Completed Date:  1999-07-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1330-6     Citation Subset:  AIM; IM    
Affiliation:
Departments of Obstetrics and Gynecology, Naval Medical Center, Medical College of Georgia, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid / physiology,  ultrasonography*
Apgar Score
Cesarean Section
Female
Fetal Blood
Fetal Distress
Humans
Hydrogen-Ion Concentration
Meconium
Oligohydramnios / ultrasonography*
Pregnancy
Pregnancy Outcome*
ROC Curve
Risk Factors
Sensitivity and Specificity
Ultrasonography, Prenatal*
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2001 Mar;184(4):778-9   [PMID:  11262491 ]

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


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