Biophysical profile with amniotic fluid volume assessments.
OBJECTIVE
To compare the amniotic fluid index (AFI) with the single deepest pocket technique along with the other components of the biophysical profile (BPP) in predicting an adverse pregnancy outcome.


METHODS
Prospective, randomized trial of amniotic fluid assessment by AFI or single deepest pocket during a BPP. Cesarean delivery for fetal distress was the primary outcome evaluated.


RESULTS
The AFI was used in 273 pregnancies and the single deepest pocket in 264. The AFI significantly increased the number of pregnancies labeled as oligohydramnios, 102 women (38%) compared with 46 women (17%; P <.001), odds ratio (OR) = 2.84, 95% confidence interval 1.90-4.25 in the single deepest pocket group. There was no difference in the number of women with oligohydramnios in the AFI group, 16 of 102 (16%), undergoing a cesarean delivery for fetal intolerance of labor compared with the single deepest pocket group, 6 of 46 (13%; P =.676). More women with normal fluid by the AFI method (AFI > 5), 20 of 170 (12%), underwent a cesarean delivery for fetal distress than the women with normal fluid by the single deepest pocket technique (2 cm x 1 cm pocket present) group, 12 of 218 (6%; P =.037, OR = 2.22, 95% confidence interval 1.05-4.70).


CONCLUSIONS
The AFI offers no advantage in detecting adverse outcomes compared with the single deepest pocket when performed with the BPP. The AFI may cause more interventions by labeling twice as many at-risk pregnancies as having oligohydramnios than with the single deepest pocket technique.
Magann
Everett F
EF
Department of Obstetrics and Gynecology, University of Western Australia, Perth Australia.
Doherty
Dorota A
DA
Field
Karen
K
Chauhan
Suneet P
SP
Muffley
Patrick E
PE
Morrison
John C
JC
D000653:Amniotic Fluid; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000628:therapy; D006801:Humans; D016104:Oligohydramnios / Q000175:diagnosis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies