Antenatal testing among 1001 patients at high risk: The role of ultrasonographic estimate of amniotic fluid volume

An Amniotic Fluid Index ≤5 cm Within 7 Days of Delivery in the Third Trimester Is Not Associated with Decreasing Umbilical Arterial pH and Base Excess

“…Casey et al 1 found no increased incidence of severe neonatal acidemia (defined as umbilical artery pH <7.0) or seizures within the first 24 hours of life when 147 cases with an AFI r5.0 cm at Z34 weeks were compared to controls with an AFI >5.0 cm. Similarly, Magann et al 11 found no statistically significant difference in mean umbilical artery pH or incidence of pH <7.10 or 7.00 when 210 cases with an AFI r5.0 cm within 1 week of delivery were compared to controls with an AFI >5.0 cm. Using umbilical arterial pH thresholds of 7.15 and 7.00, Conway et al 12 also found no difference in neonatal acidosis when 183 patients at term who underwent induction of labor secondary to AFI r5.0 cm were compared to controls with an AFI >5.0 cm admitted in spontaneous labor.…”

“…10 Absolute measurements r5 cm at any gestational age have been linked with an increase in complications in the neonate, and although it has become standard practice to initiate antenatal testing and early delivery based on this finding, not all authors have found an isolated AFI r5 cm to be a marker for fetal compromise. [10][11][12] Some investigators have found oligohydramnios to be ominous only if accompanied by growth restriction 13 or severe fetal heart rate decelerations. 14 If an AFI r5 cm identifies the fetus with uteroplacental insufficiency, there should be an association with a decrease in umbilical arterial pH and base excess at the time of birth.…”

Oligohydramnios: use and misuse in clinical management

“…Conversely, Magaan et al 82 evaluated amniotic fluid volumes in 1001 patients receiving antepartum fetal testing. Oligohydramnios defined by an AFI ≤ 5 cm occurred in approximately 20% of patients and was not associated with an increase in the incidence of non-reactive non-stress tests, meconium-stained amniotic fluid, Cesarean delivery for fetal distress, low Apgar scores, or infants with cord pH levels of < 7.10 82 .…”

“…Oligohydramnios defined by an AFI ≤ 5 cm occurred in approximately 20% of patients and was not associated with an increase in the incidence of non-reactive non-stress tests, meconium-stained amniotic fluid, Cesarean delivery for fetal distress, low Apgar scores, or infants with cord pH levels of < 7.10 82 . Accordingly, the authors concluded that the AFI was a poor diagnostic test with which to determine whether a patient is at increased risk for an adverse perinatal outcome 82 . Regarding the significance of amniotic fluid volume in patients with pregnancies complicated by severe pre-eclampsia, Schucker et al 83 retrospectively reviewed records of 136 such women managed conservatively for at least 48 h. They reported that for women with severe pre-eclampsia remote from term, an AFI of < 5 cm, although lacking sensitivity, is predictive of fetal growth restriction.…”

Isolated oligohydramnios: effects on obstetric and perinatal outcome

“…But in contradiction to these, a few studies question the entity isolated oligohydramnios at term as a predictor for Department of Obstetrics and Gynecology, Mahatma Gandhi Medical College and Research Institute, Pilliyarkuppam, Pondicherry, India adverse perinatal outcome. [8][9][10] Hence this study is done to correlate isolated oligohydramnios with adverse perinatal and obstetric outcomes.…”