TY - JOUR
T1 - Intrapartum amniotic fluid index
T2 - A poor predictor of abnormal fetal size
AU - Hendrix, Nancy W.
AU - Chauhan, Suneet P.
AU - Magann, Everett F.
AU - Martin, James N.
AU - Morrison, John C.
AU - Devoe, Lawrence D.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1998/11
Y1 - 1998/11
N2 - Objective: Using receiver-operating characteristic (ROC) curves, we tried to determine the diagnostic threshold of amniotic fluid index (AFI) that will identify abnormal fetal size (birth weights under 2500 g or at least 4000 g) at 37 weeks or beyond. Methods: We analyzed prospectively over 2 years all parturients with intact membranes and known AFI in early labor. Patients with the following conditions were excluded: pregestational or gestational diabetes, known anomalies, and preterm labor. Two ROC curves were constructed, and the areas (± standard error of the mean [SE]) under the curves were calculated. P < .05 was considered significant. Results: Of the 1038 subjects meeting study criteria, 3.6% and 11.5% gave birth to infants who were small for gestational age (SGA) or macrosomic, respectively. Overall, 28.7% had oligohydramnios (AFI at most 5.0 cm) and 3.6% had hydramnios (AFI at least 24.0 cm). Small for gestational age was more common in patients with AFI at most 5.0 cm (6.4%) than in those with adequate fluid (AFI 5.1-23.9; 2.5%), or hydramnios (2.7%; P = .012). Macrosomic newborns were less likely to be born to women with oligohydramnios (7.7%) than to those with adequate amniotic fluid (13.1%) or hydramnios (13.5%). Areas under ROC curves are not significantly different from the area under the nondiagnostic line, indicating that AFI (0-34 cm) cannot differentiate between newborns under 2500 g and at or over 2500 g or under 4000 and at or more 4000 g. Conclusion: Intraparterium AFI appears to be a poor screening test to identify risk for delivery of SGA or macrosomic fetus.
AB - Objective: Using receiver-operating characteristic (ROC) curves, we tried to determine the diagnostic threshold of amniotic fluid index (AFI) that will identify abnormal fetal size (birth weights under 2500 g or at least 4000 g) at 37 weeks or beyond. Methods: We analyzed prospectively over 2 years all parturients with intact membranes and known AFI in early labor. Patients with the following conditions were excluded: pregestational or gestational diabetes, known anomalies, and preterm labor. Two ROC curves were constructed, and the areas (± standard error of the mean [SE]) under the curves were calculated. P < .05 was considered significant. Results: Of the 1038 subjects meeting study criteria, 3.6% and 11.5% gave birth to infants who were small for gestational age (SGA) or macrosomic, respectively. Overall, 28.7% had oligohydramnios (AFI at most 5.0 cm) and 3.6% had hydramnios (AFI at least 24.0 cm). Small for gestational age was more common in patients with AFI at most 5.0 cm (6.4%) than in those with adequate fluid (AFI 5.1-23.9; 2.5%), or hydramnios (2.7%; P = .012). Macrosomic newborns were less likely to be born to women with oligohydramnios (7.7%) than to those with adequate amniotic fluid (13.1%) or hydramnios (13.5%). Areas under ROC curves are not significantly different from the area under the nondiagnostic line, indicating that AFI (0-34 cm) cannot differentiate between newborns under 2500 g and at or over 2500 g or under 4000 and at or more 4000 g. Conclusion: Intraparterium AFI appears to be a poor screening test to identify risk for delivery of SGA or macrosomic fetus.
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U2 - 10.1016/S0029-7844(98)00249-X
DO - 10.1016/S0029-7844(98)00249-X
M3 - Article
C2 - 9794676
AN - SCOPUS:0031791894
SN - 0029-7844
VL - 92
SP - 823
EP - 827
JO - Obstetrics and gynecology
JF - Obstetrics and gynecology
IS - 5
ER -