A Comparison of Amniotic Fluid Index versus Single Deepest Vertical Pocket Measurement at Term as a Predictor of Adverse Perinatal Outcome

Abstract

Introduction: Oligohydramnios is an important sign of fetal jeopardy and amniotic fluid index (AFI) and single deepest vertical pocket (SDVP) have been used to detect it. Objective: To compare AFI vs. SDVP at term as a predictor of adverse perinatal outcomes. Methods: A prospective observational study was conducted in Teaching Hospital Kandy, Sri Lanka for eight months from July 2015 to March 2016. 448 Singleton pregnancies admitted after 37 completed weeks were included. AFI ≤ 5 cm and SDVP < 2 cm were the exposure variables, which were related to outcome variables. Results: Mean AFI was 11.35 cm (SD = 5.15) and Mean SDVP was 4.07 cm (SD = 1.88). AFI and SDVP values showed a significant positive correlation (r = 0.954; p < 0.001). A significant percentage with low AFI needed induction of labour (RR 2.14, 95% CI 1.85 -2.49). Low AFI was also a significant risk factor for not having an uneventful birth outcome (RR 2.682, 95% CI 1.082 -6.642). Low SDVP was a significant risk factor for induction of labour (RR 1.83, 95% CI 1.434 -2.334), operative delivery (RR 1.714, 95% CI 1.292 -2.280), meconium-stained liquor (RR 2.67, 95% CI 1.342 -5.308), and Apgar < 7 (RR 17.74,). SDVP had better predictability than AFI for adverse perinatal outcomes. Conclusion: AFI better predicted oligohydramnios and subsequent labour induction than SDVP. Low SDVP was a risk factor for adverse perinatal outcomes (such as induction of labour, meconium-stained liquor, operative delivery, 5-minute Apgar less < 7, admission to special care baby units or perinatal deaths). In predicting adverse perinatal events, a higher potential was noted in SDVP method than AFI method. To determine the most predictive cut-off values of SDVP and AFI for each perinatal outcome, an in-depth experimental analysis is required in future research.

Diagnostic Accuracy of Cerebroplacental Ratio in Prediction of Postnatal Outcomes in Oligohydramnios

“…Oligohydramnios can be caused by multiple fetal factors, including placental malfunction, chromosomal abnormalities, medication adverse effects, and premature membrane rupture. Consequences include a higher rate of cesarean sections, meconium aspiration syndrome, critical care unit admission, and low APGAR score in newborns [ 2 ]. The results of the routine antenatal imaging with ultrasound (RADIUS) experiment, which was done on patients with isolated oligohydramnios (IO), showed that fetal growth was unaffected.…”