Document Detail


Normal ultrasonic evaluation of amniotic fluid in low-risk patients at term.
MedLine Citation:
PMID:  12216427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study women at the time of admission to the labor and delivery unit to determine which type of ultrasonographic assessment of the amniotic fluid--amniotic fluid index (AFI), single deepest vertical pocket (DVP) or amniotic fluid distribution (AFD)--had the greatest clinical utility in predicting labor complications. STUDY DESIGN: Patients not at term, with a nonvertex presentation, or with ruptured membranes, polyhydramnios, or known maternal or congenital abnormalities were excluded. We included 266 low-risk pregnant women admitted for labor. Medical charts were reviewed for documentation of meconium-stained amniotic fluid (Mec), cesarean section (C/S) for fetal indications and admissions to the neonatal intensive care unit (NICU). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for AFI, DVP and AFD were calculated in relation to the three outcome variables. Positive findings were defined as: AFI < 5.0, DVP < 2.5 cm and AFD, sum of the two lower quadrants of the AFI with a lower value than the sum of the two upper quadrants. RESULTS: Mec was documented in 56 patients (21%), 13 patients (4.8%) had a C/S for fetal indications, and 4 infants (1.5%) were admitted to the NICU. Abnormal AFI was detected in 35 patients (13%), abnormal DVP in 38 patients (14%) and abnormal AFD in 117 patients (44%). PPV and NPV for prediction of Mec, C/S and NICU were: Mec 31% and 80% for AFI, 26% and 80% for DVP; 31% and 91% for AFD; C/S 8.6% and 95% for AFI, 5% and 95% for DVP; 8.6% and 100% for AFD and NICU, 0% and 98% for AFI, 0% and 95% for DVP, and 2.7% and 99% for AFD. CONCLUSION: Normal ultrasonographic values for AFI and AFD are associated with a very low risk of labor complications.
Authors:
Thomas D Myles; Joaquin Santolaya-Forgas
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  47     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-09-09     Completed Date:  2003-01-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  621-4     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Texas Tech Health Sciences Center, 1400 Wallace Boulevard, Amarillo, TX 79106, USA. myles@cortex.ama.ttuhsc.edu
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MeSH Terms
Descriptor/Qualifier:
Amniotic Fluid / ultrasonography*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases / ultrasonography*
Labor, Obstetric
Obstetric Labor Complications / ultrasonography*
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Reproducibility of Results
Risk Assessment
Ultrasonography, Prenatal*

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


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