title: Amniotic fluid index and perinatal morbidity.
abstract: Our purpose was: (1) to determine whether assessment of amniotic fluid index in high risk patients with a reactive nonstress test (NST) allowed improved recognition of the fetus at risk for perinatal morbidity than a reactive NST alone; and (2) to determine the optimal low amniotic fluid index (AFI) which should prompt clinical concern. The last NST performed within a week of delivery and amniotic fluid index were retro-spectively compared with various indices of perinatal morbidity. In fetuses with a reactive NST, decreasing AFI was directly correlated with a risk of 5-minute Apgar score of less than 7 and delivery for fetal distress. When various subgroupings of AFI were compared, 7 cm or greater appeared to have a better inverse correlation with the indices of morbidity than lower cut-off values. The addition of AFI assessment to the standard NST allows better prediction of perinatal morbidity than the NSTs alone. Seven centimeters appears to be a reasonable cut-off for clinical concern.
authors.affiliation: Bess Kaiser Hospital, Portland, Oregon, USA.
authors.forename: D
authors.initials: D
authors.lastname: Dizon-Townson
authors.forename: K A
authors.initials: KA
authors.lastname: Kennedy
authors.forename: G A
authors.initials: GA
authors.lastname: Dildy
authors.forename: J
authors.initials: J
authors.lastname: Wu
authors.forename: M
authors.initials: M
authors.lastname: Egger
authors.forename: S L
authors.initials: SL
authors.lastname: Clark
mesh_terms: D000653:Amniotic Fluid; D001034:Apgar Score; D002585:Cesarean Section; D005189:False Positive Reactions; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis; D005323:Fetal Monitoring; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D007363:Intensive Care Units, Neonatal; D008470:Meconium; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D012307:Risk Factors