A randomized clinical trial of the intrapartum assessment of amniotic fluid volume: amniotic fluid index versus the single deepest pocket technique.
OBJECTIVE
The purpose of this study was to determine whether an intrapartum assessment of amniotic fluid identifies a pregnancy that is at risk for an adverse outcome.


METHODS
Parturients who were admitted for delivery were assigned randomly to have the amniotic fluid assessed either by amniotic fluid index or by the presence of a 2 x 1 pocket.


RESULTS
The amniotic fluid index was obtained in 499 pregnancies, and the 2 x 1 technique was performed in 501. Oligohydramnios was diagnosed in 25% of amniotic fluid index pregnancies versus 8% with the use of the 2 x 1 pocket technique (P <.001). Both techniques failed to identify patients who underwent an amnioinfusion for fetal distress (P=.864) or who experienced variable (P=.208) or late decelerations (P=.210) that influenced delivery, fetal distress in labor (P=.220), caesarean delivery for fetal distress (P=.133), and admission to neonatal intensive care unit (P=.686).


CONCLUSIONS
Neither the amniotic fluid index nor the 2 x 1 pocket technique that was undertaken as a fetal admission test identifies a pregnancy that is at risk for an adverse outcome.
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Jennifer
J
Moses
Dorota A
DA
Doherty
Everett F
EF
Magann
Suneet P
SP
Chauhan
John C
JC
Morrison
D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000000981:diagnostic imaging*; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods; D006801:Humans; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D009774:Obstetrics / Q000379:methods; D016104:Oligohydramnios / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal