title: Ultrasonography versus amniotic fluid spectral analysis: are they sensitive enough to predict neonatal complications associated with isoimmunization?
abstract: The modern management of pregnancy complicated by erythroblastosis fetalis is based on serial amniocenteses followed by either intrauterine transfusions or early delivery of affected infants, depending on the gestational age. A retrospective study was undertaken involving 92 isoimmunized pregnancies in which ultrasonography and amniotic fluid analyses were used to assess the relative predictive values for neonatal complications. Our data demonstrated that ultrasonography and optical density analyses were comparable in the evaluation of the isoimmunized pregnancy. The combined information from both these modalities did not increase the predictive value over that observed with either one alone. Both instruments were found to have high negative predictive values. However, neither method, used singly or in combination, was highly predictive of neonatal complications. In light of the low positive predictive values, caution should be exercised in using the results of amniotic fluid spectral analyses and/or ultrasound examinations for predicting perinatal complications.
authors.affiliation: Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: E A
authors.initials: EA
authors.lastname: Reece
authors.forename: S W
authors.initials: SW
authors.lastname: Cole
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: S
authors.initials: S
authors.lastname: Gabrielli
authors.forename: T Z
authors.initials: TZ
authors.lastname: O'Connor
authors.forename: J C
authors.initials: JC
authors.lastname: Hobbins
mesh_terms: D000653:Amniotic Fluid / Q000032:analysis*; D004899:Erythroblastosis, Fetal / Q000175:diagnosis; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000175:diagnosis*; D013057:Spectrum Analysis; D014463:Ultrasonography