The maximal vertical pocket and amniotic fluid index in predicting fetal distress in prolonged pregnancy

2007 ◽  
Vol 96 (2) ◽  
pp. 89-93 ◽  
Author(s):  
P. Dasari ◽  
G. Niveditta ◽  
S. Raghavan
1992 ◽  
Vol 166 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Stephen C. Robson ◽  
Robin A. Crawford ◽  
John A.D. Spencer ◽  
Angela Lee

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Ahmed Elkady ◽  
Dina Yahia Mansour ◽  
Hamada Farag Abu zaid

Abstract Background The intrapartum management of prolonged pregnancies is aunique challenge to the obstetricians, as the perinatal outcomes areadverse after completed 40 weeks. In such cases, intrapartumasphyxia and meconium aspiration are associated with almost. Objective To comparison between MVP and AFI in predicting neonatal respiratory outcomes in induction of labour in prolonged pregnancies. Patients and Methods The study was a prospective comparative study that was conducted on 266 women with prolonged pregnancy undergoing induction of labour. The patients were recruited from Ain Shams university hospitals during the period from February 2019 to August 2019. Results Amniotic fluid index and MVP were evaluated in 269 women with pregnancies of 40 or more weeks and intact membranes using a 3.5-MHz linear transducer. 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 DVP of 1 cm or less. External cardiotocography was performed during intrapartum period 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. Conclusion The use of the AFI and SDVP is useful in predicting neonatal outcomes in the induction of labor in prolonged pregnancies. The SDVP measurement appears to be the more appropriate method for predicting neonatal outcomes. The same observation was found when AFI and SDVP were combined. It is also logical to recommend that only one method should be used for fetal assessment tests.


Author(s):  
Nasreen Noor ◽  
Seema Amjad Raza ◽  
Shazia Parveen ◽  
Mohammad Khalid ◽  
Syed Manazir Ali

Background: The aim of this study is to compare the use of amniotic fluid index with maximum vertical pocket for predicting perinatal outcomes.Methods: The present study was a prospective observational study and includes 140 The study include normal antenatal women at gestational age 40 weeks or beyond (by last menstrual period/1st trimester scan) referred from antenatal between 20 to 40 years were enrolled in this study from 2015 to 2017. After Institutional Ethics Committee approval all recruited women was assessed at the 3rd trimester visit for baseline demographic and obstetric data. After taking a detailed history and examination the women were subjected to ultrasonography for Amniotic Fluid index (AFI) and Maximum vertical pocket (MVP). The women were divided into 2 groups based on measurement of AFI and MVP ultrasonologically. The correlation of Amniotic fluid index and Maximum vertical pocket with perinatal outcome were computed for the 2 groups: Group Ia - women having normal AFI and normal MVP; Group Ib - women having decreased AFI and normal MVP.Results: In Group Ia, 31(34.44%) women were induced and in Group Ib 59 (65.56%) women were induced for oligohydramnios. 65 women (72.22%) had normal vaginal delivery versus 25women (27.28%) had undergone LSCS in Group Ia, while in Group Ib, 32 women (64%) versus 18 women (36%) had vaginal delivery and LSCS respectively. Higher rate of LSCS was observed in Group Ib. There was no significant difference in the rate of LSCS for fetal distress between Group Ia and Ib for fetal distress.Conclusions: Amniotic fluid index (AFI) compared with the maximum vertical pocket (MVP) excessively characterizes patients as having oligohydramnios, leading to an increase in obstetric interventions, without any documented improvement in perinatal morbidity and mortality. Thus, authors cannot find any objective reason to favour AFI over MVP.


Author(s):  
Hema K. R. ◽  
Lalitha H. S.

Background: Perinatal morbidity and mortality are significantly increased when oligohydramnios is present. As the amniotic fluid volume decreases, the perinatal mortality rate increases. The incidence of major congenital anomalies with IUGR also increases as the amniotic fluid volume declines. There is a close association between declining placental function in the latter part of the third trimester and amniotic fluid volume1. Thus, post term patients are at a greater risk for development of oligohydramnios. Fetal anomalies that results in oligohydramnios classically involve the urinary tract. The most frequently mentioned renal anomalies include bilateral renal agenesis, multicystic dysplastic kidneys, bladder outlet obstruction and infantile polycystic kidneys.Methods: All antenatal patients seen in the Department of Obstetrics and Gynecology at Sri Siddhartha Medical College and Research Centre between January 2015 to January 2017, who were willing to participate in the trial study were enrolled. Ultrasound GE Voulson S8-PRO equipped with 3.5 MHz transducer was used to measure the amniotic fluid index. The AFI in each group was noted and the pregnancy outcome in each group was determined. At the time of delivery following data variables were collected and compiled.Results: There were 105 women, who were divided into three groups of 35 each. Those women with AFI<5 had more chances of emergency caesarian section, the causes were fetal distress with variable and late fetal heart decelerations. The incidence of meconium stained liquor and NICU admission were more.Conclusions: The women with AFI<5 had more chances of emergency caesarian section, the causes were fetal distress with variable and late fetal heart decelerations. Amniotic Fluid Index is a valuable screening test for detecting fetuses that may have poor perinatal outcome.


Author(s):  
Nalini Sharma ◽  
Hanslata Gehlot

Background: The Induction of labor in oligohydramnios poses a dilemma for obstetrician. Studies are limited with variable results. This study aims at finding whether isolated oligohydramnios is an indication for operative delivery or labor induction followed by vaginal delivery is possible.Methods: A prospective study carried out on females delivered in study duration in Umaid Hospital, Jodhpur, Rajasthan. Outcomes studied were gestational age at delivery, colour of amniotic fluid, FHR tracings, mode of delivery, indication for cesarean section or instrumental delivery, Apgar score at one minute and five minutes, birth weight, admission to Neonatal Intensive Care Unit (NICU), perinatal morbidity and perinatal mortality. Descriptive statistics were applied and data was represented on frequency tables, graphs and diagrams.Results: 40% of subjects had amniotic fluid index (AFI) <5 cm and 60% demonstrated AFI between 5-7 cm. 60% of patients induced delivered vaginally with (38.33%) having AFI <5 cm. Operative delivery was resorted to in 40% of patients. Perinatal outcomes resulted in total 97% of babies discharged in healthy condition.Conclusions: Labor induction is feasible in idiopathic oligohydramnios. Fetal distress is the most feared and predicted outcome with labor induction in oligohydramnios. This study deduced that in majority- reason for c-sections was failed labor induction due the poor Bishop's score, not fetal reasons. We hope by putting at rest apprehensions of obstetrician regarding this notion rate of c-sections could be reduced.


Author(s):  
Aashka M. Mashkaria ◽  
Babulal S. Patel ◽  
Akshay C. Shah ◽  
Shashwat K. Jani ◽  
Vismay B. Patel ◽  
...  

Background: Oligohydramnios has got a noteworthy influence on perinatal outcome. Hence, early detection and its timely management will aid in curtailing of perinatal morbidity and mortality and leading to decreased operative interventions. Therefore, the present study is conducted to look for the effects of oligohydramnios.Methods: This comparative study was a prospective observational study conducted at study institution. The women were divided into study and control groups based on AFI (amniotic fluid index), 100 cases were selected in each group.Results: Out of the 200 women, included in the present study, 35% of the patients in the study group had non-reactive non-stress test (NST) while in the control group 7% had it. Caesarean section was performed in 58% of cases in the study group as compared to 30% in the control group. Amongst these, Fetal distress was the most common indication for LSCS (lower segment caesarean section). There were no perinatal deaths in this study.Conclusions: Based on this study it has been observed that, amniotic fluid index of ≤5 cm was commonly associated with increased LSCS rates, intrauterine growth restriction, non-reactive NST, and abnormal Doppler velocimetry studies. Therefore, every case of oligohydramnios requires to be assessed meticulously. Prompt detection; timely management and treating the underlying condition improve outcome.


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