Journal article
The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study.
- Abstract:
- OBJECTIVE: To determine whether a single ultrasound scan at or beyond 40 weeks of gestation to detect a single deepest pool of amniotic fluid <2 cm and amniotic fluid index (AFI) <5 cm is clinically useful in the prediction of subsequent adverse pregnancy outcome. DESIGN: A prospective double blind cohort study. SETTING: A university teaching hospital delivering approximately 6000 women annually. POPULATION: One thousand and five hundred and eighty-four pregnant women at or beyond 40 weeks of gestation. METHODS: Ultrasound assessment of liquor to detect the single deepest pool of amniotic fluid and derive the AFI at or after 40 weeks of gestation. MAIN OUTCOME MEASURES: Perinatal death, meconium aspiration, birth asphyxia, intervention in labour for fetal distress, a cord arterial pH <7 and admission to the neonatal unit. RESULTS: An AFI <5 cm but not a single deepest pool <2 cm was significantly associated with birth asphyxia or meconium aspiration. An AFI <5 cm was also significantly associated with caesarean section for fetal distress in labour, a cord arterial pH <7 at delivery and low Apgar scores. Despite there being a statistically significant association with adverse outcomes the sensitivity of AFI was low at 28.6%, 12% and 11.5% for major adverse outcome, fetal distress in labour or admission to the neonatal unit, respectively. CONCLUSIONS: The AFI is superior to a measure of the single deepest pool as an assessment of the fetus at or after 40 weeks but has a poor sensitivity for adverse pregnancy outcome. Routine use is likely to lead to increased obstetric intervention without improvement in perinatal outcomes.
- Publication status:
- Published
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- Publisher copy:
- 10.1016/s1470-0328(03)02917-3
Authors
- Journal:
- BJOG : an international journal of obstetrics and gynaecology More from this journal
- Volume:
- 110
- Issue:
- 11
- Pages:
- 989-994
- Publication date:
- 2003-11-01
- DOI:
- EISSN:
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1471-0528
- ISSN:
-
1470-0328
- Language:
-
English
- Keywords:
-
- Pubs id:
-
pubs:175114
- UUID:
-
uuid:f0bb1055-145b-4db5-9fdf-9752855a2c73
- Local pid:
-
pubs:175114
- Source identifiers:
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175114
- Deposit date:
-
2013-11-16
- ARK identifier:
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- Copyright date:
- 2003
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