The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study
Objective To determine whether a single ultrasound scan at or beyond 40 weeks of gestation to detect a single deepest pool of amniotic fluid
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2003-11, Vol.110 (11), p.989-994 |
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| container_title | BJOG : an international journal of obstetrics and gynaecology |
| container_volume | 110 |
| creator | Morris, J.M. Thompson, K. Smithey, J. Gaffney, G. Cooke, I. Chamberlain, P. Hope, P. Altman, D. MacKenzie, I.Z. |
| description | Objective
To determine whether a single ultrasound scan at or beyond 40 weeks of gestation to detect a single deepest pool of amniotic fluid |
| doi_str_mv | 10.1111/j.1471-0528.2003.02417.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71340703</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>71340703</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4267-c6a5d94e2564db75b53541509135423168f79de69ab36a79526bd34d5c14a1963</originalsourceid><addsrcrecordid>eNqNkc1u1DAQxyMEoh_wCsgXuCX4OwkSB1pBAVXqpZwtx54sXjn2EsdL91F4W5zuil7xZUYzvxnPzL-qEMENKe_9tiG8JTUWtGsoxqzBlJO2eXhWnf9LPH_0cY0Z7c6qi5S2GBNJMXtZnREueio6dl79uf8JKCcYsw-QEoojyn6ZdYo5WKRTKsEJwrIm9BRcXJxBo8_OIhfQbgbrzOLCBmm7hzkBinkxcYJjNvoYNmBXbhN0MIcPSK_htINStQc0eBdsAeKQYN7rxcWgPUpLtodX1YtR-wSvT_ay-vHl8_311_r27ubb9afb2nAq29pILWzPgQrJ7dCKQTDBicA9KZYyIrux7S3IXg9M6rYXVA6WcSsM4Zr0kl1W7459y1y_MqRFTS4Z8F4HiDmpljCOW8wK2B1BUxZIM4xqN7tJzwdFsFplUVu1Xl-t11erLOpRFvVQSt-c_sjDBPap8KRDAd6eAJ2M9uNcjuXSEyd6ScuGhft45H47D4f_HkBdfb9bPfYXxgOrkA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71340703</pqid></control><display><type>article</type><title>The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study</title><source>MEDLINE</source><source>Wiley Online Library</source><source>Alma/SFX Local Collection</source><creator>Morris, J.M. ; Thompson, K. ; Smithey, J. ; Gaffney, G. ; Cooke, I. ; Chamberlain, P. ; Hope, P. ; Altman, D. ; MacKenzie, I.Z.</creator><creatorcontrib>Morris, J.M. ; Thompson, K. ; Smithey, J. ; Gaffney, G. ; Cooke, I. ; Chamberlain, P. ; Hope, P. ; Altman, D. ; MacKenzie, I.Z.</creatorcontrib><description><![CDATA[Objective
To determine whether a single ultrasound scan at or beyond 40 weeks of gestation to detect a single deepest pool of amniotic fluid <2 cm and amniotic fluid index (AFI) <5 cm is clinically useful in the prediction of subsequent adverse pregnancy outcome.
Design
A prospective double blind cohort study.
Setting
A university teaching hospital delivering approximately 6000 women annually.
Population
One thousand and five hundred and eighty‐four pregnant women at or beyond 40 weeks of gestation.
Methods
Ultrasound assessment of liquor to detect the single deepest pool of amniotic fluid and derive the AFI at or after 40 weeks of gestation.
Main outcome measures
Perinatal death, meconium aspiration, birth asphyxia, intervention in labour for fetal distress, a cord arterial pH <7 and admission to the neonatal unit.
Results
An AFI <5 cm but not a single deepest pool <2 cm was significantly associated with birth asphyxia or meconium aspiration. An AFI <5 cm was also significantly associated with caesarean section for fetal distress in labour, a cord arterial pH <7 at delivery and low Apgar scores. Despite there being a statistically significant association with adverse outcomes the sensitivity of AFI was low at 28.6%, 12% and 11.5% for major adverse outcome, fetal distress in labour or admission to the neonatal unit, respectively.
Conclusions
The AFI is superior to a measure of the single deepest pool as an assessment of the fetus at or after 40 weeks but has a poor sensitivity for adverse pregnancy outcome. Routine use is likely to lead to increased obstetric intervention without improvement in perinatal outcomes.]]></description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/j.1471-0528.2003.02417.x</identifier><identifier>PMID: 14592583</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Adult ; Amniotic Fluid ; Asphyxia Neonatorum - etiology ; Biological and medical sciences ; Cohort Studies ; Diseases of mother, fetus and pregnancy ; Double-Blind Method ; Female ; Fetal Blood ; Fetal Distress - etiology ; Gynecology. Andrology. Obstetrics ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Intensive Care, Neonatal - statistics & numerical data ; Meconium Aspiration Syndrome - etiology ; Medical sciences ; Obstetric Labor Complications - etiology ; Obstetric Labor Complications - therapy ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Prolonged ; Pregnancy. Fetus. Placenta ; Prospective Studies ; Risk Factors ; Sensitivity and Specificity ; Ultrasonography, Prenatal - methods</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2003-11, Vol.110 (11), p.989-994</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4267-c6a5d94e2564db75b53541509135423168f79de69ab36a79526bd34d5c14a1963</citedby><cites>FETCH-LOGICAL-c4267-c6a5d94e2564db75b53541509135423168f79de69ab36a79526bd34d5c14a1963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1471-0528.2003.02417.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1471-0528.2003.02417.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15962256$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14592583$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morris, J.M.</creatorcontrib><creatorcontrib>Thompson, K.</creatorcontrib><creatorcontrib>Smithey, J.</creatorcontrib><creatorcontrib>Gaffney, G.</creatorcontrib><creatorcontrib>Cooke, I.</creatorcontrib><creatorcontrib>Chamberlain, P.</creatorcontrib><creatorcontrib>Hope, P.</creatorcontrib><creatorcontrib>Altman, D.</creatorcontrib><creatorcontrib>MacKenzie, I.Z.</creatorcontrib><title>The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description><![CDATA[Objective
To determine whether a single ultrasound scan at or beyond 40 weeks of gestation to detect a single deepest pool of amniotic fluid <2 cm and amniotic fluid index (AFI) <5 cm is clinically useful in the prediction of subsequent adverse pregnancy outcome.
Design
A prospective double blind cohort study.
Setting
A university teaching hospital delivering approximately 6000 women annually.
Population
One thousand and five hundred and eighty‐four pregnant women at or beyond 40 weeks of gestation.
Methods
Ultrasound assessment of liquor to detect the single deepest pool of amniotic fluid and derive the AFI at or after 40 weeks of gestation.
Main outcome measures
Perinatal death, meconium aspiration, birth asphyxia, intervention in labour for fetal distress, a cord arterial pH <7 and admission to the neonatal unit.
Results
An AFI <5 cm but not a single deepest pool <2 cm was significantly associated with birth asphyxia or meconium aspiration. An AFI <5 cm was also significantly associated with caesarean section for fetal distress in labour, a cord arterial pH <7 at delivery and low Apgar scores. Despite there being a statistically significant association with adverse outcomes the sensitivity of AFI was low at 28.6%, 12% and 11.5% for major adverse outcome, fetal distress in labour or admission to the neonatal unit, respectively.
Conclusions
The AFI is superior to a measure of the single deepest pool as an assessment of the fetus at or after 40 weeks but has a poor sensitivity for adverse pregnancy outcome. Routine use is likely to lead to increased obstetric intervention without improvement in perinatal outcomes.]]></description><subject>Adult</subject><subject>Amniotic Fluid</subject><subject>Asphyxia Neonatorum - etiology</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Double-Blind Method</subject><subject>Female</subject><subject>Fetal Blood</subject><subject>Fetal Distress - etiology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Hydrogen-Ion Concentration</subject><subject>Infant, Newborn</subject><subject>Intensive Care, Neonatal - statistics & numerical data</subject><subject>Meconium Aspiration Syndrome - etiology</subject><subject>Medical sciences</subject><subject>Obstetric Labor Complications - etiology</subject><subject>Obstetric Labor Complications - therapy</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy, Prolonged</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Ultrasonography, Prenatal - methods</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAQxyMEoh_wCsgXuCX4OwkSB1pBAVXqpZwtx54sXjn2EsdL91F4W5zuil7xZUYzvxnPzL-qEMENKe_9tiG8JTUWtGsoxqzBlJO2eXhWnf9LPH_0cY0Z7c6qi5S2GBNJMXtZnREueio6dl79uf8JKCcYsw-QEoojyn6ZdYo5WKRTKsEJwrIm9BRcXJxBo8_OIhfQbgbrzOLCBmm7hzkBinkxcYJjNvoYNmBXbhN0MIcPSK_htINStQc0eBdsAeKQYN7rxcWgPUpLtodX1YtR-wSvT_ay-vHl8_311_r27ubb9afb2nAq29pILWzPgQrJ7dCKQTDBicA9KZYyIrux7S3IXg9M6rYXVA6WcSsM4Zr0kl1W7459y1y_MqRFTS4Z8F4HiDmpljCOW8wK2B1BUxZIM4xqN7tJzwdFsFplUVu1Xl-t11erLOpRFvVQSt-c_sjDBPap8KRDAd6eAJ2M9uNcjuXSEyd6ScuGhft45H47D4f_HkBdfb9bPfYXxgOrkA</recordid><startdate>200311</startdate><enddate>200311</enddate><creator>Morris, J.M.</creator><creator>Thompson, K.</creator><creator>Smithey, J.</creator><creator>Gaffney, G.</creator><creator>Cooke, I.</creator><creator>Chamberlain, P.</creator><creator>Hope, P.</creator><creator>Altman, D.</creator><creator>MacKenzie, I.Z.</creator><general>Blackwell Science Ltd</general><general>Blackwell</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>200311</creationdate><title>The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study</title><author>Morris, J.M. ; Thompson, K. ; Smithey, J. ; Gaffney, G. ; Cooke, I. ; Chamberlain, P. ; Hope, P. ; Altman, D. ; MacKenzie, I.Z.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4267-c6a5d94e2564db75b53541509135423168f79de69ab36a79526bd34d5c14a1963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Amniotic Fluid</topic><topic>Asphyxia Neonatorum - etiology</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Double-Blind Method</topic><topic>Female</topic><topic>Fetal Blood</topic><topic>Fetal Distress - etiology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Hydrogen-Ion Concentration</topic><topic>Infant, Newborn</topic><topic>Intensive Care, Neonatal - statistics & numerical data</topic><topic>Meconium Aspiration Syndrome - etiology</topic><topic>Medical sciences</topic><topic>Obstetric Labor Complications - etiology</topic><topic>Obstetric Labor Complications - therapy</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy, Prolonged</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Ultrasonography, Prenatal - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morris, J.M.</creatorcontrib><creatorcontrib>Thompson, K.</creatorcontrib><creatorcontrib>Smithey, J.</creatorcontrib><creatorcontrib>Gaffney, G.</creatorcontrib><creatorcontrib>Cooke, I.</creatorcontrib><creatorcontrib>Chamberlain, P.</creatorcontrib><creatorcontrib>Hope, P.</creatorcontrib><creatorcontrib>Altman, D.</creatorcontrib><creatorcontrib>MacKenzie, I.Z.</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>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morris, J.M.</au><au>Thompson, K.</au><au>Smithey, J.</au><au>Gaffney, G.</au><au>Cooke, I.</au><au>Chamberlain, P.</au><au>Hope, P.</au><au>Altman, D.</au><au>MacKenzie, I.Z.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2003-11</date><risdate>2003</risdate><volume>110</volume><issue>11</issue><spage>989</spage><epage>994</epage><pages>989-994</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><abstract><![CDATA[Objective
To determine whether a single ultrasound scan at or beyond 40 weeks of gestation to detect a single deepest pool of amniotic fluid <2 cm and amniotic fluid index (AFI) <5 cm is clinically useful in the prediction of subsequent adverse pregnancy outcome.
Design
A prospective double blind cohort study.
Setting
A university teaching hospital delivering approximately 6000 women annually.
Population
One thousand and five hundred and eighty‐four pregnant women at or beyond 40 weeks of gestation.
Methods
Ultrasound assessment of liquor to detect the single deepest pool of amniotic fluid and derive the AFI at or after 40 weeks of gestation.
Main outcome measures
Perinatal death, meconium aspiration, birth asphyxia, intervention in labour for fetal distress, a cord arterial pH <7 and admission to the neonatal unit.
Results
An AFI <5 cm but not a single deepest pool <2 cm was significantly associated with birth asphyxia or meconium aspiration. An AFI <5 cm was also significantly associated with caesarean section for fetal distress in labour, a cord arterial pH <7 at delivery and low Apgar scores. Despite there being a statistically significant association with adverse outcomes the sensitivity of AFI was low at 28.6%, 12% and 11.5% for major adverse outcome, fetal distress in labour or admission to the neonatal unit, respectively.
Conclusions
The AFI is superior to a measure of the single deepest pool as an assessment of the fetus at or after 40 weeks but has a poor sensitivity for adverse pregnancy outcome. Routine use is likely to lead to increased obstetric intervention without improvement in perinatal outcomes.]]></abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>14592583</pmid><doi>10.1111/j.1471-0528.2003.02417.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1470-0328 |
| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2003-11, Vol.110 (11), p.989-994 |
| issn | 1470-0328 1471-0528 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_71340703 |
| source | MEDLINE; Wiley Online Library; Alma/SFX Local Collection |
| subjects | Adult Amniotic Fluid Asphyxia Neonatorum - etiology Biological and medical sciences Cohort Studies Diseases of mother, fetus and pregnancy Double-Blind Method Female Fetal Blood Fetal Distress - etiology Gynecology. Andrology. Obstetrics Humans Hydrogen-Ion Concentration Infant, Newborn Intensive Care, Neonatal - statistics & numerical data Meconium Aspiration Syndrome - etiology Medical sciences Obstetric Labor Complications - etiology Obstetric Labor Complications - therapy Pregnancy Pregnancy Outcome Pregnancy, Prolonged Pregnancy. Fetus. Placenta Prospective Studies Risk Factors Sensitivity and Specificity Ultrasonography, Prenatal - methods |
| title | The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy: a prospective blinded observational study |
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