Document Detail


Earlier gestational age at ultrasound evaluation predicts adverse neonatal outcomes in the preterm appropriate-for-gestational-age fetus with idiopathic oligohydramnios.
MedLine Citation:
PMID:  18843586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Oligohydramnios is related to adverse perinatal outcomes particularly when associated with fetal growth restriction. The purpose of this study was to delineate predictors of adverse perinatal outcomes in cases of preterm idiopathic oligohydramnios associated with appropriate-for-gestational-age (AGA) fetal biometry. A database of preterm AGA fetuses (< 37 weeks) presenting for evaluation of idiopathic oligohydramnios (defined as an amniotic fluid index [AFI] < 10th percentile) in the third trimester with delivery information and uterine artery Doppler indices (average resistance index [RI] and bilateral notching) available was prospectively collected ( N = 90). AFI and birth weight (BW) percentiles were calculated using standard tables. Chi-square and Student T test were used to evaluate for predictors of adverse perinatal outcomes including BW < or = 10th percentile, stillbirth, neonatal intensive care unit admission, 5-minute Apgar score < 7, preterm delivery < 35 weeks, and preeclampsia. Patients destined to experience poor perinatal outcomes (22%) were demographically similar to those experiencing normal outcomes in terms of maternal age ( P = 0.5), ethnicity ( P = 0.9), body mass index ( P = 0.3), and parity ( P = 0.9). However, at-risk patients were more likely to present with oligohydramnios at an earlier gestational age (GA) than those not at risk (33.0 +/- 3.0 versus 34.4 +/- 2.0 weeks; P = 0.02). There were no differences in perinatal outcomes associated with AFI percentile ( P = 0.9), increased average uterine artery RI ( P = 0.5), bilateral notching ( P = 0.4) or a combination of increased uterine artery RI and bilateral notching ( P = 0.2). Patients with preterm AGA fetuses who present with idiopathic oligohydramnios at an earlier GA are at risk for adverse perinatal outcomes compared with those presenting later in gestation. Sonographic indices, particularly uterine artery Doppler findings, were not found to be useful predictors of adverse outcomes.
Authors:
Joy Vink; Kimberly Hickey; Alessandro Ghidini; Shad Deering; Adrian Mora; Sarah Poggi
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Publication Detail:
Type:  Journal Article     Date:  2008-10-08
Journal Detail:
Title:  American journal of perinatology     Volume:  26     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-30     Completed Date:  2009-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  21-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Georgetown University Hospital, Washington, D.C. 20007, USA. joyvink@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Amniotic Fluid
Apgar Score
Arteries / ultrasonography
Birth Weight
Body Mass Index
Delivery, Obstetric
Ethnic Groups
Female
Forecasting
Gestational Age*
Humans
Infant, Newborn
Intensive Care, Neonatal
Maternal Age
Oligohydramnios / physiopathology*,  ultrasonography
Parity
Placental Circulation / physiology
Pre-Eclampsia / physiopathology
Pregnancy
Pregnancy Outcome*
Pregnancy Trimester, Third
Premature Birth / physiopathology*
Prospective Studies
Stillbirth
Ultrasonography, Doppler
Ultrasonography, Prenatal*
Uterus / blood supply

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


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