Ultrasound estimation of amniotic fluid volume using the largest vertical pocket containing umbilical cord: measure to or through the cord?

Magann, E. F.; Chauhan, Suneet P.; Washington, W. J.; Whitworth, Neil S.; Martin, James N.; Morrison, John C.

doi:10.1046/j.1469-0705.2002.00802.x

Cited by 12 publications

(7 citation statements)

References 8 publications

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“…The amniotic fluid index (AFI) is measured by dividing the uterus into four quadrants and the deepest unobstructed vertical pockets of fluid are measured in centimeters and then added to calculate. The normal value ranges from 5cm to 25cm 2,3 .…”

Section: Introductionmentioning

confidence: 99%

A prospective cohort study of perinatal outcomes: pregnancies with isolated oligohydramnios versus normal pregnancies

Musthaq

Kodithuwakku

Shireen

et al. 2019

Sri Lanka J Obstet & Gynae

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Key words: isolated oligohydramnios, amniotic fluid index, perinatal outcome Background: Pregnancies with oligohydramnios at term in the absence of fetal and maternal compromise pose a dilemma in management. Evidence regarding the outcome of these pregnancies are controversial, and it is one of the common reason for early induction of labour in the fear of adverse perinatal outcome. Outcomes of such pregnancies are not adequately studied in Sri Lankan setting.Objective: To compare the perinatal fetal outcomes of isolated oligohydramnios with normal pregnancy at term among women who were admitted to Teaching Hospital Kandy.Methods: A prospective cohort study was carried out. All the pregnant mothers admitted to ward 7 Teaching Hospital Kandy at term were routinely scanned for fetal growth and amniotic fluid volume. Women with isolated oligohydramnios (n=70) and without any other pregnancy-related complications were selected as controls. Two controls (normal pregnancy n=140) were selected per case matching the age and parity. These pregnant mothers were followed up from the date of admission to discharge. Immediate perinatal fetal and postnatal outcomes were assessed. Data were entered and analyzed by SPSS 22.0. Results:The majority of the patients (58.5%) with isolated oligohydramnios were induced early, and a significant number of these patients have undergone emergency caesarean section (X 2 =12.98, p=0.003). Although pregnancies with isolated oligohydramnios tends to have more CTG abnormalities, it was not statistically significant (X 2 =4.29, p=0.12). But, the incidence of significant meconium-stained liquor was higher than normal pregnancies (X 2 =6.02, p=0.049). However, the fetal outcome APGAR <7 at 5 minutes (X 2 =0.33, p=0.95) short term perinatal morbidities (X 2 =0.29, p= 0.59) were shown no statistical difference between both group. Neonatal special care baby unit admissions were higher in pregnancies with isolated oligohydramnios (X 2 =23.56, p=0.0001). Conclusion and recommendation:Compared to normal pregnancies, pregnancies with isolated oligohydramnios didn't show any statistically significant difference in perinatal outcome. Oligohydramnios itself doesn't indicate the fetal compromise when other growth parameters were normal. However, as there are controversies in management further researches are needed in this field.

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Section: Introductionmentioning

confidence: 99%

A prospective cohort study of perinatal outcomes: pregnancies with isolated oligohydramnios versus normal pregnancies

Musthaq

Kodithuwakku

Shireen

et al. 2019

Sri Lanka J Obstet & Gynae

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“…The timing of delivery was customized based on the gestational age, the severity of the disease—depending on the results of fetal surveillance, the parents’ decisions, and a team of senior consultants, including neonatologists. If the internal policy was not changed by the attending physician (increasing or decreasing the intensity of prenatal care and the frequency of medical visits) or on parental desire (e.g., transfer to another unit or fetal abandonment), we proceeded as follows: In prestage I (defined as EFW between 10th centile and the 3rd centile), we used weekly US monitoring regardless of the GA—amniotic fluid volume assessment (using the deepest vertical pocket technique—DVP [ 24 ]), fetal biophysical profile (BPP) [ 25 ] and Doppler interrogation at the two fetal sites (UmbA and MCA), the CPR, both UtA and pulsatility index (PI); in this stage, we used US for EFW every two weeks. If the BPP and Dopplers were normal, expectance was proposed until 32 WG, and the case was discarded from the study.…”

Section: Methodsmentioning

confidence: 99%

Early Onset Intrauterine Growth Restriction—Data from a Tertiary Care Center in a Middle-Income Country

et al. 2022

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Background and Objectives: In this study, we aimed to describe the clinical and ultrasound (US) features and the outcome in a group of patients suspected of or diagnosed with early onset intrauterine growth restriction (IUGR) requiring iatrogenic delivery before 32 weeks, having no structural or genetic fetal anomalies, managed in our unit. A secondary aim was to report the incidence of the condition in the population cared for in our hospital, data on immediate postnatal follow-up in these cases and to highlight the differences required in prenatal and postnatal care. Materials and Methods: We used as single criteria for defining the suspicion of early IUGR the sonographic estimation of fetal weight <p10 using the Hadlock 4 technique at any scan performed before 32 weeks’ gestation (WG). We used a cohort of patients having a normal evolution in pregnancy and uneventful vaginal births as controls. Data on pregnancy ultrasound, characteristics and neonatal outcomes were collected and analyzed. We hypothesized that the gestational age (GA) at delivery is related to the severity of the condition. Therefore, we performed a subanalysis in two subgroups, which were divided based on the GA at iatrogenic delivery (between 27+0 WG and 29+6 WG and 30+0–32+0 WG, respectively). Results: The prospective cohort study included 36 pregnancies. We had three cases of intrauterine fetal death (8.3%). The incidence was 1.98% in our population. We confirmed that severe cases (very early diagnosed and delivered) were associated with a higher number of prenatal visits and higher uterine arteries (UtA) pulsatility index (PI) centile in the third trimester—TT (compared with the early diagnosed and delivered). In the very early suspected IUGR subgroup, the newborns required significantly more NICU days and total hospitalization days. Conclusions: Patients with isolated very early and early IUGR—defined as ultrasound (US) estimation of fetal weight <p10 using the Hadlock 4 technique requiring iatrogenic delivery before 32 weeks’ gestation—require closer care prenatally and postnatally. These patients represent an economical burden for the health system, needing significantly longer hospitalization intervals, GA at birth and UtA PI centiles being related to it.

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“…Measurements obtained were for uterine artery Doppler, umbilical artery Doppler, cerebral artery Doppler, estimated fetal weight utilizing biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC) and femur length (FL) [12] and amniotic fluid index (AFI). Normal AFI values ranged from 5 to 25 cm [13][14][15][16]. Cases were assessed for development of pregnancy complications such as preeclampsia, intrauterine growth restriction (IUGR) and preterm labor.…”

Section: Methodsmentioning

confidence: 99%

Low molecular weight heparin in pregnancies with persistently abnormal uterine artery Doppler, does it make a difference? A prospective proof of concept study

Fattah

2021

Clin. Exp. Obstet. Gynecol.

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Trophoblastic invasion converts the uteroplacental circulation into a low resistance, high capacitance system. Defective invasion causes hypoperfusion and pregnancy complications. Early pregnancy uterine artery Doppler demonstrates low end-diastolic velocities. Its PI and RI decrease with increasing gestation. Aim of the study: Examing the e fect of adding low molecular weight heparin (LMWH) to low-dose aspirin on persistent high uterine artery Doppler indices and its impact on fetal growth and pregnancy outcome. Patients and methods: A ter approval of Alexandria university ethics committee, pregnant cases with positive past history of placental vascular complication including; placental abruption, preeclampsia, small-for-gestational age (SGA) pregnancies and fetal growth restriction were recruited. All selected patients were in good general health without previous history of Diabetes Mellitus or thyroid disorders or cardiac diseases. Patients with thrombocytopenia, bleeding tendencies, multiple pregnancies, and pregnancies complicated by fetal or neonatal chromosomal or structural anomalies were excluded from the study. Eligible patients were 412, all were subjected to uterine artery Doppler measurement in the first trimester. 148 cases had high uterine artery Doppler PI, they were given low dose aspirin and were re-evaluated at 22--24 weeks gestation. 58 cases had persistently high uterine artery Doppler PI, they were allocated into 2 groups each of 29 cases; Group A LMWH with aspirin. Group B only low dose aspirin. 50 pregnants with normal uterine artery Doppler PI from the start were taken as a control group. All participants were followed up at 28--30 and 34--36 weeks. Primary outcome: Normal uterine, umbilical and cerebral artery Doppler measurements a ter LMWH. Secondary outcome: Prevention of pregnancy complications and neonatal complications. Results: Uterine and umbilical artery Doppler and amount of liquor significantly improved. Conclusion: LMWH in luenced uterine artery and umbilical Doppler measurements and amount of liquor and reduced the risk of neonatal hypoxic ischaemic encephalopathy.

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Ultrasound estimation of amniotic fluid volume using the largest vertical pocket containing umbilical cord: measure to or through the cord?

Abstract: For the detection of low amniotic fluid volumes, the AFI to the cord is better than through the cord. Measurement to the cord and through the cord had similar accuracy for both the AFI and SDP techniques in normal and high dye-determined amniotic fluid volumes.

Cited by 12 publications

References 8 publications

A prospective cohort study of perinatal outcomes: pregnancies with isolated oligohydramnios versus normal pregnancies

A prospective cohort study of perinatal outcomes: pregnancies with isolated oligohydramnios versus normal pregnancies

Early Onset Intrauterine Growth Restriction—Data from a Tertiary Care Center in a Middle-Income Country

Low molecular weight heparin in pregnancies with persistently abnormal uterine artery Doppler, does it make a difference? A prospective proof of concept study

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