Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis
Objective: Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score 5.0 cm, is associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 2.2; 95% confidence interval, 1.5-3.4) and an Apgar...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 1999-12, Vol.181 (6), p.1473-1478 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Chauhan, Suneet P. Sanderson, Maureen Hendrix, Nancy W. Magann, Everett F. Devoe, Lawrence D. |
| description | Objective: Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score 5.0 cm, is associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 2.2; 95% confidence interval, 1.5-3.4) and an Apgar score of |
| doi_str_mv | 10.1016/S0002-9378(99)70393-5 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69362532</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002937899703935</els_id><sourcerecordid>69362532</sourcerecordid><originalsourceid>FETCH-LOGICAL-c537t-9570f590052a4402482b453d22d748ed55383bfa0778127f3cecfe3d20e488223</originalsourceid><addsrcrecordid>eNqFkEtr3DAQgEVpSDaPn9DiQynpwakeliXlUkLoIxBIIe1ZzEpjqmDLG0kOzb-vvbu0ufUywzDfPPgIecPoBaOs_XhPKeW1EUqfG_NBUWFELV-RFaNG1a1u9Wuy-osckeOcH5aSG35IjhhtKTOCrQh-xxQiFOircSpuHLCC6CsYYhhLcFXXT8FXIXr8Pceq_Fr6BTeQyjRs0RBLgn29mZeNPl9WV9WABWqI0D_nkE_JQQd9xrN9PiE_v3z-cf2tvr37enN9dVs7KVSpjVS0k4ZSyaFpKG80XzdSeM69ajR6KYUW6w6oUppx1QmHrsO5T7HRmnNxQt7v9m7S-DhhLnYI2WHfQ8RxyrY1ouVSLKDcgS6NOSfs7CaFAdKzZdQufu3Wr13kWWPs1q-V89zb_YFpPaB_MbUTOgPv9gBkB32XILqQ_3GccanVjH3aYTjbeAqYbHYBo0MfErpi_Rj-88kfI3WW1w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69362532</pqid></control><display><type>article</type><title>Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Chauhan, Suneet P. ; Sanderson, Maureen ; Hendrix, Nancy W. ; Magann, Everett F. ; Devoe, Lawrence D.</creator><creatorcontrib>Chauhan, Suneet P. ; Sanderson, Maureen ; Hendrix, Nancy W. ; Magann, Everett F. ; Devoe, Lawrence D.</creatorcontrib><description><![CDATA[Objective: Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score <7, and umbilical arterial pH <7.00 in patients with antepartum or intrapartum amniotic fluid index >5.0 or <5.0 cm. Study Design: Using a MEDLINE search, we reviewed all studies published between 1987 and 1997 that correlated antepartum or intrapartum amniotic fluid index with adverse peripartum outcomes. The inclusion criteria were studies in English that associated at least one of the selected adverse outcomes with an amniotic fluid index of ≤5.0 cm versus >5.0 cm. Contingency tables were constructed for each study, and relative risks and standard errors of their logs were calculated. Fixed–effects pooled relative risks were calculated for groups of studies that were homogeneous, whereas random-effects pooled relative risks were calculated for significantly heterogeneous groups of studies. Results: Eighteen reports describing 10,551 patients met our inclusion criteria. An antepartum amniotic fluid index of ≤5.0 cm, in comparison with >5.0 cm, is associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 2.2; 95% confidence interval, 1.5-3.4) and an Apgar score of <7 at 5 minutes (pooled relative risk, 5.2; 95% confidence interval, 2.4-11.3). An intrapartum amniotic fluid index of ≤5.0 cm is also associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 1.7; 95% confidence interval, 1.1-2.6) and an Apgar score <7 at 5 minutes (pooled relative risk, 1.8; 95% confidence interval, 1.2-2.7). A poor correlation between the amniotic fluid index and neonatal acidosis was noted in the only study that examined this end point. More than 23,000 patients are necessary to demonstrate that the incidence of umbilical arterial pH <7.00 is 1.5 times higher among those with oligohydramnios in labor than among those with adequate amniotic fluid index (α = 0.05; β = 0.2) Conclusions: An antepartum or intrapartum amniotic fluid index of ≤5.0 cm is associated with a significantly increased risk of cesarean delivery for fetal distress and a low Apgar score at 5 minutes. There are few reports linking amniotic fluid index and neonatal acidosis, the only objective assessment of fetal well-being. A multicenter study with sufficient power should be undertaken to demonstrate that a low amniotic fluid index is associated with an umbilical arterial pH <7.00. (Am J Obstet Gynecol 1999;181:1473-8.)]]></description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1016/S0002-9378(99)70393-5</identifier><identifier>PMID: 10601931</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Acidosis - epidemiology ; Amniotic Fluid - diagnostic imaging ; amniotic fluid index ; Apgar Score ; Biological and medical sciences ; Cesarean Section - statistics & numerical data ; Female ; Fetal Blood - chemistry ; Fetal Distress - diagnostic imaging ; Fetal Distress - surgery ; Gynecology. Andrology. Obstetrics ; Humans ; Hydrogen-Ion Concentration ; Incidence ; Infant, Newborn ; Management. Prenatal diagnosis ; Medical sciences ; meta-analysis ; Perinatal outcome ; Predictive Value of Tests ; Pregnancy ; Pregnancy Outcome ; Pregnancy. Fetus. Placenta ; Risk Factors ; Ultrasonography, Prenatal - standards</subject><ispartof>American journal of obstetrics and gynecology, 1999-12, Vol.181 (6), p.1473-1478</ispartof><rights>1999 Mosby, Inc.</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c537t-9570f590052a4402482b453d22d748ed55383bfa0778127f3cecfe3d20e488223</citedby><cites>FETCH-LOGICAL-c537t-9570f590052a4402482b453d22d748ed55383bfa0778127f3cecfe3d20e488223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937899703935$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1212587$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10601931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chauhan, Suneet P.</creatorcontrib><creatorcontrib>Sanderson, Maureen</creatorcontrib><creatorcontrib>Hendrix, Nancy W.</creatorcontrib><creatorcontrib>Magann, Everett F.</creatorcontrib><creatorcontrib>Devoe, Lawrence D.</creatorcontrib><title>Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description><![CDATA[Objective: Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score <7, and umbilical arterial pH <7.00 in patients with antepartum or intrapartum amniotic fluid index >5.0 or <5.0 cm. Study Design: Using a MEDLINE search, we reviewed all studies published between 1987 and 1997 that correlated antepartum or intrapartum amniotic fluid index with adverse peripartum outcomes. The inclusion criteria were studies in English that associated at least one of the selected adverse outcomes with an amniotic fluid index of ≤5.0 cm versus >5.0 cm. Contingency tables were constructed for each study, and relative risks and standard errors of their logs were calculated. Fixed–effects pooled relative risks were calculated for groups of studies that were homogeneous, whereas random-effects pooled relative risks were calculated for significantly heterogeneous groups of studies. Results: Eighteen reports describing 10,551 patients met our inclusion criteria. An antepartum amniotic fluid index of ≤5.0 cm, in comparison with >5.0 cm, is associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 2.2; 95% confidence interval, 1.5-3.4) and an Apgar score of <7 at 5 minutes (pooled relative risk, 5.2; 95% confidence interval, 2.4-11.3). An intrapartum amniotic fluid index of ≤5.0 cm is also associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 1.7; 95% confidence interval, 1.1-2.6) and an Apgar score <7 at 5 minutes (pooled relative risk, 1.8; 95% confidence interval, 1.2-2.7). A poor correlation between the amniotic fluid index and neonatal acidosis was noted in the only study that examined this end point. More than 23,000 patients are necessary to demonstrate that the incidence of umbilical arterial pH <7.00 is 1.5 times higher among those with oligohydramnios in labor than among those with adequate amniotic fluid index (α = 0.05; β = 0.2) Conclusions: An antepartum or intrapartum amniotic fluid index of ≤5.0 cm is associated with a significantly increased risk of cesarean delivery for fetal distress and a low Apgar score at 5 minutes. There are few reports linking amniotic fluid index and neonatal acidosis, the only objective assessment of fetal well-being. A multicenter study with sufficient power should be undertaken to demonstrate that a low amniotic fluid index is associated with an umbilical arterial pH <7.00. (Am J Obstet Gynecol 1999;181:1473-8.)]]></description><subject>Acidosis - epidemiology</subject><subject>Amniotic Fluid - diagnostic imaging</subject><subject>amniotic fluid index</subject><subject>Apgar Score</subject><subject>Biological and medical sciences</subject><subject>Cesarean Section - statistics & numerical data</subject><subject>Female</subject><subject>Fetal Blood - chemistry</subject><subject>Fetal Distress - diagnostic imaging</subject><subject>Fetal Distress - surgery</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Incidence</subject><subject>Infant, Newborn</subject><subject>Management. Prenatal diagnosis</subject><subject>Medical sciences</subject><subject>meta-analysis</subject><subject>Perinatal outcome</subject><subject>Predictive Value of Tests</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Risk Factors</subject><subject>Ultrasonography, Prenatal - standards</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtr3DAQgEVpSDaPn9DiQynpwakeliXlUkLoIxBIIe1ZzEpjqmDLG0kOzb-vvbu0ufUywzDfPPgIecPoBaOs_XhPKeW1EUqfG_NBUWFELV-RFaNG1a1u9Wuy-osckeOcH5aSG35IjhhtKTOCrQh-xxQiFOircSpuHLCC6CsYYhhLcFXXT8FXIXr8Pceq_Fr6BTeQyjRs0RBLgn29mZeNPl9WV9WABWqI0D_nkE_JQQd9xrN9PiE_v3z-cf2tvr37enN9dVs7KVSpjVS0k4ZSyaFpKG80XzdSeM69ajR6KYUW6w6oUppx1QmHrsO5T7HRmnNxQt7v9m7S-DhhLnYI2WHfQ8RxyrY1ouVSLKDcgS6NOSfs7CaFAdKzZdQufu3Wr13kWWPs1q-V89zb_YFpPaB_MbUTOgPv9gBkB32XILqQ_3GccanVjH3aYTjbeAqYbHYBo0MfErpi_Rj-88kfI3WW1w</recordid><startdate>19991201</startdate><enddate>19991201</enddate><creator>Chauhan, Suneet P.</creator><creator>Sanderson, Maureen</creator><creator>Hendrix, Nancy W.</creator><creator>Magann, Everett F.</creator><creator>Devoe, Lawrence D.</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19991201</creationdate><title>Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis</title><author>Chauhan, Suneet P. ; Sanderson, Maureen ; Hendrix, Nancy W. ; Magann, Everett F. ; Devoe, Lawrence D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c537t-9570f590052a4402482b453d22d748ed55383bfa0778127f3cecfe3d20e488223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Acidosis - epidemiology</topic><topic>Amniotic Fluid - diagnostic imaging</topic><topic>amniotic fluid index</topic><topic>Apgar Score</topic><topic>Biological and medical sciences</topic><topic>Cesarean Section - statistics & numerical data</topic><topic>Female</topic><topic>Fetal Blood - chemistry</topic><topic>Fetal Distress - diagnostic imaging</topic><topic>Fetal Distress - surgery</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Incidence</topic><topic>Infant, Newborn</topic><topic>Management. Prenatal diagnosis</topic><topic>Medical sciences</topic><topic>meta-analysis</topic><topic>Perinatal outcome</topic><topic>Predictive Value of Tests</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Risk Factors</topic><topic>Ultrasonography, Prenatal - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chauhan, Suneet P.</creatorcontrib><creatorcontrib>Sanderson, Maureen</creatorcontrib><creatorcontrib>Hendrix, Nancy W.</creatorcontrib><creatorcontrib>Magann, Everett F.</creatorcontrib><creatorcontrib>Devoe, Lawrence D.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chauhan, Suneet P.</au><au>Sanderson, Maureen</au><au>Hendrix, Nancy W.</au><au>Magann, Everett F.</au><au>Devoe, Lawrence D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>1999-12-01</date><risdate>1999</risdate><volume>181</volume><issue>6</issue><spage>1473</spage><epage>1478</epage><pages>1473-1478</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract><![CDATA[Objective: Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score <7, and umbilical arterial pH <7.00 in patients with antepartum or intrapartum amniotic fluid index >5.0 or <5.0 cm. Study Design: Using a MEDLINE search, we reviewed all studies published between 1987 and 1997 that correlated antepartum or intrapartum amniotic fluid index with adverse peripartum outcomes. The inclusion criteria were studies in English that associated at least one of the selected adverse outcomes with an amniotic fluid index of ≤5.0 cm versus >5.0 cm. Contingency tables were constructed for each study, and relative risks and standard errors of their logs were calculated. Fixed–effects pooled relative risks were calculated for groups of studies that were homogeneous, whereas random-effects pooled relative risks were calculated for significantly heterogeneous groups of studies. Results: Eighteen reports describing 10,551 patients met our inclusion criteria. An antepartum amniotic fluid index of ≤5.0 cm, in comparison with >5.0 cm, is associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 2.2; 95% confidence interval, 1.5-3.4) and an Apgar score of <7 at 5 minutes (pooled relative risk, 5.2; 95% confidence interval, 2.4-11.3). An intrapartum amniotic fluid index of ≤5.0 cm is also associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 1.7; 95% confidence interval, 1.1-2.6) and an Apgar score <7 at 5 minutes (pooled relative risk, 1.8; 95% confidence interval, 1.2-2.7). A poor correlation between the amniotic fluid index and neonatal acidosis was noted in the only study that examined this end point. More than 23,000 patients are necessary to demonstrate that the incidence of umbilical arterial pH <7.00 is 1.5 times higher among those with oligohydramnios in labor than among those with adequate amniotic fluid index (α = 0.05; β = 0.2) Conclusions: An antepartum or intrapartum amniotic fluid index of ≤5.0 cm is associated with a significantly increased risk of cesarean delivery for fetal distress and a low Apgar score at 5 minutes. There are few reports linking amniotic fluid index and neonatal acidosis, the only objective assessment of fetal well-being. A multicenter study with sufficient power should be undertaken to demonstrate that a low amniotic fluid index is associated with an umbilical arterial pH <7.00. (Am J Obstet Gynecol 1999;181:1473-8.)]]></abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>10601931</pmid><doi>10.1016/S0002-9378(99)70393-5</doi><tpages>6</tpages></addata></record> |
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| ispartof | American journal of obstetrics and gynecology, 1999-12, Vol.181 (6), p.1473-1478 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Acidosis - epidemiology Amniotic Fluid - diagnostic imaging amniotic fluid index Apgar Score Biological and medical sciences Cesarean Section - statistics & numerical data Female Fetal Blood - chemistry Fetal Distress - diagnostic imaging Fetal Distress - surgery Gynecology. Andrology. Obstetrics Humans Hydrogen-Ion Concentration Incidence Infant, Newborn Management. Prenatal diagnosis Medical sciences meta-analysis Perinatal outcome Predictive Value of Tests Pregnancy Pregnancy Outcome Pregnancy. Fetus. Placenta Risk Factors Ultrasonography, Prenatal - standards |
| title | Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis |
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