TY - JOUR
T1 - Isolated low-normal amniotic fluid volume in the early third trimester
T2 - Association with adverse perinatal outcomes
AU - Hashimoto, Kazumasa
AU - Kasdaglis, Tania
AU - Jain, Sheveta
AU - Atkins, Kristin
AU - Harman, Chris R.
AU - Baschat, Ahmet A.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2013/7
Y1 - 2013/7
N2 - Aims: To test if an isolated finding of low-normal amniotic fluid index (AFI) in the early third trimester in low-risk patients is associated with adverse perinatal outcomes. Methods: Retrospective cohort study with uncomplicated singleton pregnancies that had ultrasound studies between 28.0 and 31.9 weeks ' gestation. Two cohorts with AFI 8.0 - 11.9 cm (low-normal, LN) and AFI 12.0 - 19.9 cm (mid-normal, MN) were compared. Results: Patients with LN-AFI (n=99) were more likely to have early (=34 weeks) and late (=37 weeks) preterm birth (PTB) (relative risk 4.2 and 2.4, respectively) and a small for gestational age (SGA) infant (relative risk 1.8) than MN-AFI (n=834), corresponding to a higher NICU admission rate (relative risk 2.5). The risk of " spontaneous " PTB (preterm labor and rupture of membranes) did not differ between the cohorts, whereas the risk of " indicated " PTB (maternal or fetal indications) was significantly increased in LN-AFI. The incidence of abnormal antepartum testing, stillbirth, preeclampsia, placental abruption, fetal intolerance to labor, emergency cesarean delivery, umbilical artery pH=7.0, Apgar scores=7 at 5 min, and neonatal death was not increased in patients with LN-AFI. Conclusion: Low-normal AFI in the early third trimester increases the risk for subsequent delivery of an SGA infant and indicated PTB.
AB - Aims: To test if an isolated finding of low-normal amniotic fluid index (AFI) in the early third trimester in low-risk patients is associated with adverse perinatal outcomes. Methods: Retrospective cohort study with uncomplicated singleton pregnancies that had ultrasound studies between 28.0 and 31.9 weeks ' gestation. Two cohorts with AFI 8.0 - 11.9 cm (low-normal, LN) and AFI 12.0 - 19.9 cm (mid-normal, MN) were compared. Results: Patients with LN-AFI (n=99) were more likely to have early (=34 weeks) and late (=37 weeks) preterm birth (PTB) (relative risk 4.2 and 2.4, respectively) and a small for gestational age (SGA) infant (relative risk 1.8) than MN-AFI (n=834), corresponding to a higher NICU admission rate (relative risk 2.5). The risk of " spontaneous " PTB (preterm labor and rupture of membranes) did not differ between the cohorts, whereas the risk of " indicated " PTB (maternal or fetal indications) was significantly increased in LN-AFI. The incidence of abnormal antepartum testing, stillbirth, preeclampsia, placental abruption, fetal intolerance to labor, emergency cesarean delivery, umbilical artery pH=7.0, Apgar scores=7 at 5 min, and neonatal death was not increased in patients with LN-AFI. Conclusion: Low-normal AFI in the early third trimester increases the risk for subsequent delivery of an SGA infant and indicated PTB.
KW - Amniotic fluid index
KW - Low-normal AFI
KW - Perinatal outcome
KW - Third trimester
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U2 - 10.1515/jpm-2012-0130
DO - 10.1515/jpm-2012-0130
M3 - Article
C2 - 23241578
AN - SCOPUS:84881583311
SN - 0300-5577
VL - 41
SP - 349
EP - 353
JO - Journal of Perinatal Medicine
JF - Journal of Perinatal Medicine
IS - 4
ER -