Intrapartum amniotic fluid index and two-diameter pocket are poor predictors of adverse neonatal outcome.
OBJECTIVE
The objective of this study was to determine whether amniotic fluid index < or = 5.0 cm or two-diameter pocket volume < or = 15 cm2 is a predictor of abdominal delivery because of fetal distress or of Apgar score < 7 at 1 or 5 minutes.


METHODS
The study was prospective and involved 209 parturients in early labor who had ultrasonographic assessment of amniotic fluid volume by both methods.


RESULTS
The incidences of cesarean delivery because of fetal distress and of Apgar scores < 7 at 1 and 5 minutes were 8.1%, 9.0%, and 1.9%, respectively. Only Apgar scores < 7 at 1 minute were significantly higher among patients with a two-diameter pocket < 15 cm2 (16/114) as compared with > 15(2) (3/95, p = 0.007). Oligohydramnios by either method was a poor predictor of adverse outcomes (p values ranging from 0.06 to 0.21). Receiver-operating characteristic curves generated for the amniotic fluid index or two-diameter pocket to predict abdominal delivery because of fetal distress or Apgar scores < 7 at 1 minute indicate that both methods are poor diagnostic tests to predict these complications.


CONCLUSIONS
Intrapartum assessment of amniotic fluid volume, by amniotic fluid index or the two-diameter pocket technique, is a poor predictor of adverse neonatal outcome.
Chauhan
S P
SP
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505, USA.
Magann
E F
EF
Perry
K G
KG
Morrison
J C
JC
D000653:Amniotic Fluid / Q000000981:diagnostic imaging*; D001034:Apgar Score; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D016104:Oligohydramnios / Q000000981:diagnostic imaging; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal