title: Effect of fetal movement on the amniotic fluid index in diamniotic twin gestations.
abstract: Fetal movement changes the size and location of amniotic fluid pockets during measurement of the amniotic fluid index. In singleton gestations, the effect of redistributing the fixed intrauterine fluid volume on the amniotic fluid index is clinically insignificant. In this study, we tested the hypothesis that the index in twin pregnancies is unaffected by fetal movement. A single examiner prospectively determined the amniotic fluid index before and after three discrete episodes of movement by both fetuses of 82 diamniotic twin pregnancies referred for obstetric sonograms between 20 and 38 weeks' menstrual age. A reliable blinded examiner provided a second post-movement measurement as a control. Data were analyzed by the paired t-test. The mean change in the amniotic fluid index after fetal movement was 2.1 +/- 0.2 cm and 3.7 +/- 0.3 cm for post-movement determinations by the same and blinded examiners, respectively (p < .001). Interobserver variation was 3.5 cm. Intraobserver variation was 1.8 cm for the first examiner and 2.2 cm for the second examiner. Therefore, interobserver and intraobserver variation can account for the observed change in the amniotic fluid index following movement of both diamniotic twins.
authors.affiliation: Department of Obstetrics and Gynecology, Naval Medical Center, Portsmouth, Virginia 23708, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Wax
authors.forename: E
authors.initials: E
authors.lastname: Henderson
mesh_terms: D000653:Amniotic Fluid / Q000000981:diagnostic imaging*; D005260:Female; D005324:Fetal Movement / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D015588:Observer Variation; D011247:Pregnancy; D011446:Prospective Studies; D016037:Single-Blind Method; D014427:Twins; D016216:Ultrasonography, Prenatal