Document Detail

The effect of oligohydramnios on detection of fetal anomalies with sonography.
MedLine Citation:
PMID:  9168737     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The sonographic examination of fetuses is generally thought to be compromised when oligohydramnios is present because of the subjective impression of less adequate visualization of fetal anatomy. The aim of this study was to evaluate the extent to which oligohydramnios limits our ability to detect major anomalies on sonograms. MATERIALS AND METHODS: Records from the University of California, San Francisco from March 4, 1989 through January 4, 1994, were reviewed to identify all cases of premature rupture of the membranes in patients who then underwent nontargeted sonography. Sonographic results in pregnancies with oligohydramnios and without oligohydramnios (control population) were compared. Follow-up was obtained from a perinatal database, autopsy reports, and medical records. RESULTS: We found 345 patients with a history of premature rupture of the membranes (175 with oligohydramnios, 170 without oligohydramnios). Gestational age of fetuses was 16-38 weeks. Major congenital anomalies, including hydronephrosis, ventriculomegaly, intestinal atresias, hydrops, congenital diaphragmatic hernia, skeletal dysplasias, cloacal malformations, and gastroschisis, were revealed on sonography in 13 of 175 pregnancies with oligohydramnios and in 17 of the 170 pregnancies in the control group. Major anomalies missed in the oligohydramnios group included cardiac anomalies, club foot, small ventral hernia, limb reduction defect, and anal atresia. Major anomalies missed in the control group were club foot, anal atresia, and tracheoesophageal fistula. All of the major anomalies missed in both groups were of the type that are known to be difficult to diagnose before birth and that are frequently missed on sonography. CONCLUSION: Although oligohydramnios subjectively degrades image resolution, sonography still reveals important fetal anatomic landmarks. Major anomalies can be detected on sonography even when the pregnancy has less than the normal amount of amniotic fluid.
D Levine; R B Goldstein; P W Callen; N Damato; S Kilpatrick
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  168     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-06-24     Completed Date:  1997-06-24     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1609-11     Citation Subset:  AIM; IM    
Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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MeSH Terms
Case-Control Studies
Fetal Diseases / ultrasonography*
Fetal Membranes, Premature Rupture / ultrasonography*
Fetus / abnormalities*
Oligohydramnios / ultrasonography*
Ultrasonography, Prenatal*

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