Int J Gynaecol Obstet. 2007 Feb;96(2):89-93.
The maximal vertical pocket and amniotic fluid index in predicting fetal
distress in prolonged pregnancy.
Dasari P, Niveditta G, Raghavan S.
Department of Obstetrics and Gynecology, Jawaharlal Institute of
Postgraduate Medical Education and Research, Pondicherry, India. pdasari@jipmer.edu
<pdasari@jipmer.edu>
Objectives:
To determine cut-off values for amniotic fluid volume (AFV)
predictive of fetal distress in pregnancies 40 weeks or longer, assessed
using both amniotic fluid index (AFI) and height of the of maximal
vertical pocket (MVP).
Methods:
Amniotic fluid index and MVP were
evaluated in 100 women with pregnancies of 40 or more weeks and intact
membranes using a 3.5-MHz linear transducer less than 1 week prior to
onset of labor. Both measurements were obtained for each participant by
the same obstetrician in one sitting. Oligohydramnios was defined as an
AFI of 5 cm or less or an MVP of 3 cm or less. External cardiotocography
was performed during intrapartum in all cases. Fetal distress was
diagnosed when any one of the nonreassuring fetal heart rate pattern
occurred or when the Apgar score at birth was 6 or less. The results
were analyzed by the chi(2) and the t tests.
Results:
An AFI of 5 cm or
less was a better predictor of fetal distress than an MVP of 3 cm or
less (P=0.000). The most statistically significant cut-off values for
the occurrence of fetal distress in prolonged pregnancies were an AFI of
8 cm or less (odds ratio, 7.50) or an MVP of 2 cm or less (odds ratio,
2.67). There was a significant correlation between these 2 methods
(r=+0.67), with a level of significance of 0.01, as shown by the
regression curve. The secondary outcome was the statistically
significant association between meconium-stained liquor and fetal
distress (P=0.001).
Conclusion:
In pregnancies of 40 weeks or longer
there was a risk of fetal distress when the AFV was 8 cm or less by the
AFI method or 2 cm or less as measured by MVP. In such cases, intensive
intrapartum monitoring should be performed to prevent fetal jeopardy.
Thank you for choosing to visit us.
This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
If you still have unanswered questions, please consider entering them into one of our forums and I will try to assist you.
