Intrapartum oligohydramnios does not predict adverse peripartum outcome among high-risk parturients

S. P. Chauhan, N. W. Hendrix, J. C. Morrison, E. F. Magann, Lawrence D Devoe, T. Siddiqi, R. Perkins

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

OBJECTIVE: Oligohydramnios can be defined by an amniotic fluid index <5th percentile for gestational age or an amniotic fluid index ≤5.0 cm regardless of gestational age. The purpose of this prospective study was to determine whether oligohydramnios by either definition predicts accurately, in a high-risk population, the risks for cesarean section for fetal distress, Apgar score <7 at 5 minutes, and neonatal acidosis. STUDY DESIGN: An amniotic fluid index was obtained in 490 consecutive parturients with medical or obstetric complications and a reliable gestational age. After each delivery, an umbilical arterial blood gas analysis was obtained. Both measures of amniotic fluid index were rated as screening tests with use of sensitivity, specificity, predictive values, and receiver-operator characteristic curves. RESULTS: The incidences of cesarean section for fetal distress and umbilical arterial pH <7.00 were 14% and 1.8%, respectively. The 70 neonates delivered by cesarean section for distress, compared with the 420 without, had a significantly higher incidence of pH <7.00 (8.5% vs 0.7%, p = 0.0004, relative risk 5.0, 95% confidence interval 2.9 to 8.4). Sensitivity and positive predictive values of an amniotic fluid index <5th percentile for gestational age to predict pH <7.00 were 0.8% and 22%, respectively, and for an amniotic fluid index ≤5.0 cm, 0.5% and 11%, respectively. Receiver- operator characteristic curves indicate that an amniotic fluid index between 0 and 20 cm cannot predict accurately which parturients will have cesarean sections for distress or be delivered of a newborn with a low Apgar score at 5 minutes or a pH <7.10. CONCLUSION: Both criteria for oligohydramnios are poor predictors of adverse outcome for high-risk intrapartum patients.

Original languageEnglish (US)
Pages (from-to)1130-1138
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume176
Issue number6
DOIs
StatePublished - Jan 1 1997

Fingerprint

Oligohydramnios
Peripartum Period
Amniotic Fluid
Parturition
Cesarean Section
Gestational Age
Umbilicus
Fetal Distress
Apgar Score
Newborn Infant
Blood Gas Analysis
Incidence
Acidosis
Obstetrics
Prospective Studies
Confidence Intervals
Sensitivity and Specificity

Keywords

  • Amniotic fluid index
  • Fetal distress
  • Neonatal acidosis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Intrapartum oligohydramnios does not predict adverse peripartum outcome among high-risk parturients. / Chauhan, S. P.; Hendrix, N. W.; Morrison, J. C.; Magann, E. F.; Devoe, Lawrence D; Siddiqi, T.; Perkins, R.

In: American Journal of Obstetrics and Gynecology, Vol. 176, No. 6, 01.01.1997, p. 1130-1138.

Research output: Contribution to journalArticle

Chauhan, S. P. ; Hendrix, N. W. ; Morrison, J. C. ; Magann, E. F. ; Devoe, Lawrence D ; Siddiqi, T. ; Perkins, R. / Intrapartum oligohydramnios does not predict adverse peripartum outcome among high-risk parturients. In: American Journal of Obstetrics and Gynecology. 1997 ; Vol. 176, No. 6. pp. 1130-1138.
@article{2c032c79a39f456c8adf96510da7d6f1,
title = "Intrapartum oligohydramnios does not predict adverse peripartum outcome among high-risk parturients",
abstract = "OBJECTIVE: Oligohydramnios can be defined by an amniotic fluid index <5th percentile for gestational age or an amniotic fluid index ≤5.0 cm regardless of gestational age. The purpose of this prospective study was to determine whether oligohydramnios by either definition predicts accurately, in a high-risk population, the risks for cesarean section for fetal distress, Apgar score <7 at 5 minutes, and neonatal acidosis. STUDY DESIGN: An amniotic fluid index was obtained in 490 consecutive parturients with medical or obstetric complications and a reliable gestational age. After each delivery, an umbilical arterial blood gas analysis was obtained. Both measures of amniotic fluid index were rated as screening tests with use of sensitivity, specificity, predictive values, and receiver-operator characteristic curves. RESULTS: The incidences of cesarean section for fetal distress and umbilical arterial pH <7.00 were 14{\%} and 1.8{\%}, respectively. The 70 neonates delivered by cesarean section for distress, compared with the 420 without, had a significantly higher incidence of pH <7.00 (8.5{\%} vs 0.7{\%}, p = 0.0004, relative risk 5.0, 95{\%} confidence interval 2.9 to 8.4). Sensitivity and positive predictive values of an amniotic fluid index <5th percentile for gestational age to predict pH <7.00 were 0.8{\%} and 22{\%}, respectively, and for an amniotic fluid index ≤5.0 cm, 0.5{\%} and 11{\%}, respectively. Receiver- operator characteristic curves indicate that an amniotic fluid index between 0 and 20 cm cannot predict accurately which parturients will have cesarean sections for distress or be delivered of a newborn with a low Apgar score at 5 minutes or a pH <7.10. CONCLUSION: Both criteria for oligohydramnios are poor predictors of adverse outcome for high-risk intrapartum patients.",
keywords = "Amniotic fluid index, Fetal distress, Neonatal acidosis",
author = "Chauhan, {S. P.} and Hendrix, {N. W.} and Morrison, {J. C.} and Magann, {E. F.} and Devoe, {Lawrence D} and T. Siddiqi and R. Perkins",
year = "1997",
month = "1",
day = "1",
doi = "10.1016/S0002-9378(97)70326-0",
language = "English (US)",
volume = "176",
pages = "1130--1138",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Intrapartum oligohydramnios does not predict adverse peripartum outcome among high-risk parturients

AU - Chauhan, S. P.

AU - Hendrix, N. W.

AU - Morrison, J. C.

AU - Magann, E. F.

AU - Devoe, Lawrence D

AU - Siddiqi, T.

AU - Perkins, R.

PY - 1997/1/1

Y1 - 1997/1/1

N2 - OBJECTIVE: Oligohydramnios can be defined by an amniotic fluid index <5th percentile for gestational age or an amniotic fluid index ≤5.0 cm regardless of gestational age. The purpose of this prospective study was to determine whether oligohydramnios by either definition predicts accurately, in a high-risk population, the risks for cesarean section for fetal distress, Apgar score <7 at 5 minutes, and neonatal acidosis. STUDY DESIGN: An amniotic fluid index was obtained in 490 consecutive parturients with medical or obstetric complications and a reliable gestational age. After each delivery, an umbilical arterial blood gas analysis was obtained. Both measures of amniotic fluid index were rated as screening tests with use of sensitivity, specificity, predictive values, and receiver-operator characteristic curves. RESULTS: The incidences of cesarean section for fetal distress and umbilical arterial pH <7.00 were 14% and 1.8%, respectively. The 70 neonates delivered by cesarean section for distress, compared with the 420 without, had a significantly higher incidence of pH <7.00 (8.5% vs 0.7%, p = 0.0004, relative risk 5.0, 95% confidence interval 2.9 to 8.4). Sensitivity and positive predictive values of an amniotic fluid index <5th percentile for gestational age to predict pH <7.00 were 0.8% and 22%, respectively, and for an amniotic fluid index ≤5.0 cm, 0.5% and 11%, respectively. Receiver- operator characteristic curves indicate that an amniotic fluid index between 0 and 20 cm cannot predict accurately which parturients will have cesarean sections for distress or be delivered of a newborn with a low Apgar score at 5 minutes or a pH <7.10. CONCLUSION: Both criteria for oligohydramnios are poor predictors of adverse outcome for high-risk intrapartum patients.

AB - OBJECTIVE: Oligohydramnios can be defined by an amniotic fluid index <5th percentile for gestational age or an amniotic fluid index ≤5.0 cm regardless of gestational age. The purpose of this prospective study was to determine whether oligohydramnios by either definition predicts accurately, in a high-risk population, the risks for cesarean section for fetal distress, Apgar score <7 at 5 minutes, and neonatal acidosis. STUDY DESIGN: An amniotic fluid index was obtained in 490 consecutive parturients with medical or obstetric complications and a reliable gestational age. After each delivery, an umbilical arterial blood gas analysis was obtained. Both measures of amniotic fluid index were rated as screening tests with use of sensitivity, specificity, predictive values, and receiver-operator characteristic curves. RESULTS: The incidences of cesarean section for fetal distress and umbilical arterial pH <7.00 were 14% and 1.8%, respectively. The 70 neonates delivered by cesarean section for distress, compared with the 420 without, had a significantly higher incidence of pH <7.00 (8.5% vs 0.7%, p = 0.0004, relative risk 5.0, 95% confidence interval 2.9 to 8.4). Sensitivity and positive predictive values of an amniotic fluid index <5th percentile for gestational age to predict pH <7.00 were 0.8% and 22%, respectively, and for an amniotic fluid index ≤5.0 cm, 0.5% and 11%, respectively. Receiver- operator characteristic curves indicate that an amniotic fluid index between 0 and 20 cm cannot predict accurately which parturients will have cesarean sections for distress or be delivered of a newborn with a low Apgar score at 5 minutes or a pH <7.10. CONCLUSION: Both criteria for oligohydramnios are poor predictors of adverse outcome for high-risk intrapartum patients.

KW - Amniotic fluid index

KW - Fetal distress

KW - Neonatal acidosis

UR - http://www.scopus.com/inward/record.url?scp=0030759598&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030759598&partnerID=8YFLogxK

U2 - 10.1016/S0002-9378(97)70326-0

DO - 10.1016/S0002-9378(97)70326-0

M3 - Article

VL - 176

SP - 1130

EP - 1138

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 6

ER -