Amniotic fluid Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):352-357
DOI 10.1590/S0100-72032007000700005
PURPOSE: to analyze the pattern of fetal breathing movements (FBM) in diabetic pregnant women in the third trimester of pregnancy. METHODS: sixteen pregestational diabetic and 16 nondiabetic (control group) pregnant subjects were included fulfilling the following criteria: singleton, between 36-40 weeks of gestation, absence of other maternal diseases and absence of fetal anomalies. The fetal biophysical profile (FBP) was performed to evaluate the following parameters: fetal heart rate, FBM, fetal body movements, fetal tone and amniotic fluid index. The FBM was evaluated for 30 minutes, period when the examination was integrally recorded in VHS video for posterior analysis of the number of FBM episodes, the duration of each episode and the fetal breathing movements index (BMI). The BMI was calculated by the formula: (interval of time with FBM/total time of observation) x 100. At the beginning and in the end of the FBP maternal glucose levels were checked. The results were analyzed by the Mann-Whitney U-test and the Fisher exact test, adopting a level of significance of 5%. RESULTS: the glucose levels demonstrated significantly superior average in the diabetic group (113.3±35.3 g/dL) in relation to the normal group (78.2±14.8 g/dL, p<0.001). The average of the amniotic fluid index was higher in the group of the diabetic cases (15.5±6.4 cm) when compared with controls (10.6±2.0 cm; p=0.01). The average of the number of FBM episodes was superior in the diabetic ones (22.6±4.4) in relation to controls (14.8±2.3; p<0.0001). The average of the BMI in the diabetic patients (54.6±14.8%) was significantly higher than that in the control group (30.5±7.4%, p<0.0001). CONCLUSIONS: the elevated blood glucose levels can be associated with a different pattern in the FBM of diabetic mothers. The use of this parameter of the FBP, in the obstetric practice, must be considered with concern in diabetic pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(7):352-357
DOI 10.1590/S0100-72032007000700005
PURPOSE: to analyze the pattern of fetal breathing movements (FBM) in diabetic pregnant women in the third trimester of pregnancy. METHODS: sixteen pregestational diabetic and 16 nondiabetic (control group) pregnant subjects were included fulfilling the following criteria: singleton, between 36-40 weeks of gestation, absence of other maternal diseases and absence of fetal anomalies. The fetal biophysical profile (FBP) was performed to evaluate the following parameters: fetal heart rate, FBM, fetal body movements, fetal tone and amniotic fluid index. The FBM was evaluated for 30 minutes, period when the examination was integrally recorded in VHS video for posterior analysis of the number of FBM episodes, the duration of each episode and the fetal breathing movements index (BMI). The BMI was calculated by the formula: (interval of time with FBM/total time of observation) x 100. At the beginning and in the end of the FBP maternal glucose levels were checked. The results were analyzed by the Mann-Whitney U-test and the Fisher exact test, adopting a level of significance of 5%. RESULTS: the glucose levels demonstrated significantly superior average in the diabetic group (113.3±35.3 g/dL) in relation to the normal group (78.2±14.8 g/dL, p<0.001). The average of the amniotic fluid index was higher in the group of the diabetic cases (15.5±6.4 cm) when compared with controls (10.6±2.0 cm; p=0.01). The average of the number of FBM episodes was superior in the diabetic ones (22.6±4.4) in relation to controls (14.8±2.3; p<0.0001). The average of the BMI in the diabetic patients (54.6±14.8%) was significantly higher than that in the control group (30.5±7.4%, p<0.0001). CONCLUSIONS: the elevated blood glucose levels can be associated with a different pattern in the FBM of diabetic mothers. The use of this parameter of the FBP, in the obstetric practice, must be considered with concern in diabetic pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):443-448
DOI 10.1590/S0100-72031998000800003
Purpose: to demonstrate the interobserver variation existing in the ultrasonographic measurement of amniotic fluid index (AFI) and in the measurement of pocket area, and to compare these two methods. In addition, an attempt was made to establish the intraobserver variation in the measurement of this index. Methods: values of AFI, described by Phelan et al.18, were studied in a group of 80 pregnant women considered to be clinically normal, seen at the Ultrasonography and Medical Updating School of Ribeirão Preto and in the Department of Gynecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP). All pregnant women had a gestational age of more than 24 weeks. Fifty of these patients were submitted to AFI evaluation by 5 different ultrasonographists using the same equipment and during the same period of time, in order to determine the interobserver variation of this index. In addition, planimetric measurement of the area was performed by 2 of these 5 ultrasonographists, selected at random, in an attempt to determine interobserver variation in area measurement. Another group of 30 pregnant women was evaluated by the same ultrasonographist in an attempt to evaluate intraobserver variation in terms of AFI measurement. Results: There was a significant interobserver variation in AFI measurement and a significant variation in area measurement. However, the intraobserver variation in AFI measurement was nonsignificant. There was a correlation between AFI and area measurements. Conclusions: we emphasize the obstetrical applicability of this index and the easier execution of this method compared to area measurement, despite the importance of both procedures.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):443-448
DOI 10.1590/S0100-72031998000800003
Purpose: to demonstrate the interobserver variation existing in the ultrasonographic measurement of amniotic fluid index (AFI) and in the measurement of pocket area, and to compare these two methods. In addition, an attempt was made to establish the intraobserver variation in the measurement of this index. Methods: values of AFI, described by Phelan et al.18, were studied in a group of 80 pregnant women considered to be clinically normal, seen at the Ultrasonography and Medical Updating School of Ribeirão Preto and in the Department of Gynecology and Obstetrics of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP). All pregnant women had a gestational age of more than 24 weeks. Fifty of these patients were submitted to AFI evaluation by 5 different ultrasonographists using the same equipment and during the same period of time, in order to determine the interobserver variation of this index. In addition, planimetric measurement of the area was performed by 2 of these 5 ultrasonographists, selected at random, in an attempt to determine interobserver variation in area measurement. Another group of 30 pregnant women was evaluated by the same ultrasonographist in an attempt to evaluate intraobserver variation in terms of AFI measurement. Results: There was a significant interobserver variation in AFI measurement and a significant variation in area measurement. However, the intraobserver variation in AFI measurement was nonsignificant. There was a correlation between AFI and area measurements. Conclusions: we emphasize the obstetrical applicability of this index and the easier execution of this method compared to area measurement, despite the importance of both procedures.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):575-580
DOI 10.1590/S0100-72032006001000002
PURPOSE: To determine the values of amniotic fluid in normal fetuses during the first trimester of pregnancy by three- and bi-dimensional ultrasonography. METHODS: In a prospective longitudinal study, 25 normal fetuses were evaluated from the 8th to the 11th week of gestation. Amniotic fluid volume was measured by endovaginal ultrasonography with the three- and two-dimensional modes. The two-dimensional study consisted of volumetric determination by mathematical calculation based on an ellipsoidal shape (constant 0.52) to obtain the amniotic sac and embryo volumes. In the three-dimensional study, the amniotic fluid volume was determined by the VOCAL technique using 6, 9, 15, and 30 degrees of rotation. The amniotic fluid volume obtained by 6-degree rotations was considered to be the final result. In both modes, amniotic fluid volume was obtained by subtracting the volume of the embryo from the volume of the amniotic sac. Data were analyzed statistically for variance (ANOVA), correlation and regression analysis. The level of significance was set at p < 0.05. RESULTS: The amniotic fluid volume as measured by two-dimensional ultrasonography increased from 5.45 to 39.52 cm³ in the range from the 8th to the 11th week (ANOVA - p < 0.05). There was a correlation between gestational age and amniotic fluid volume (p < 0.001, r² = 88.3%). In the three-dimensional study, the amniotic fluid volume increased from 5.7 to 42.9 cm³ in the range from the 8th to the 11th week (ANOVA - p < 0.05), and again a correlation between gestational age and amniotic fluid volume (p < 0.001, r² = 98.1%) was observed. CONCLUSION: an increase in amniotic fluid volume occurs during the first trimester of pregnancy, as determined by the two- and three-dimensional modes. In addition, we have demonstrated that the higher the gestational age, the larger the amniotic fluid volume.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):575-580
DOI 10.1590/S0100-72032006001000002
PURPOSE: To determine the values of amniotic fluid in normal fetuses during the first trimester of pregnancy by three- and bi-dimensional ultrasonography. METHODS: In a prospective longitudinal study, 25 normal fetuses were evaluated from the 8th to the 11th week of gestation. Amniotic fluid volume was measured by endovaginal ultrasonography with the three- and two-dimensional modes. The two-dimensional study consisted of volumetric determination by mathematical calculation based on an ellipsoidal shape (constant 0.52) to obtain the amniotic sac and embryo volumes. In the three-dimensional study, the amniotic fluid volume was determined by the VOCAL technique using 6, 9, 15, and 30 degrees of rotation. The amniotic fluid volume obtained by 6-degree rotations was considered to be the final result. In both modes, amniotic fluid volume was obtained by subtracting the volume of the embryo from the volume of the amniotic sac. Data were analyzed statistically for variance (ANOVA), correlation and regression analysis. The level of significance was set at p < 0.05. RESULTS: The amniotic fluid volume as measured by two-dimensional ultrasonography increased from 5.45 to 39.52 cm³ in the range from the 8th to the 11th week (ANOVA - p < 0.05). There was a correlation between gestational age and amniotic fluid volume (p < 0.001, r² = 88.3%). In the three-dimensional study, the amniotic fluid volume increased from 5.7 to 42.9 cm³ in the range from the 8th to the 11th week (ANOVA - p < 0.05), and again a correlation between gestational age and amniotic fluid volume (p < 0.001, r² = 98.1%) was observed. CONCLUSION: an increase in amniotic fluid volume occurs during the first trimester of pregnancy, as determined by the two- and three-dimensional modes. In addition, we have demonstrated that the higher the gestational age, the larger the amniotic fluid volume.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):460-466
DOI 10.1590/S0100-72032006000800004
PURPOSE: to assess the performance of lamellar body count compared to the shake (Clements) test in the prediction of fetal lung maturity in diabetics. METHODS: prospective study of 62 patients who underwent amniocentesis between the 26th and 39th week of pregnancy. Immediately after collection, the amniotic fluid sample was submitted to the shake test and lamellar body count. Deliveries occurred within three days of amniocentesis. Immature test results (absence of a complete bubble ring in the third tube for the shake test and less than 50,000 lamellar bodies) were confronted with the occurrence of pulmonary immaturity in the neonate (respiratory distress syndrome). The performance of both tests was compared using the chi2 test and p<0.05 was considered to be significant. RESULTS: seven infants had respiratory distress syndrome (11.3%). The lamellar body count and shake test were similar regarding sensitivity (100 vs 71.4%, respectively) and negative predictive value (100 vs 93.5%). Lamellar body count was superior as regards specificity (87.3 vs 52.7%, p=0.0001), positive predictive value (50 vs 16.1%, p=0.017), and accuracy (88.7 vs 54.8%, p<0.001). CONCLUSIONS: lamellar body count is a simple and accurate method of assessing fetal lung maturity. It performs slightly better than the shake test in terms of specificity, positive predictive value and accuracy, with the advantage of not requiring manipulation or reagents. Similar to the shake test, lamellar body count has a high-negative predictive value: mature results (50,000 or more) indicate thar the infant will not have hyaline membrane.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(8):460-466
DOI 10.1590/S0100-72032006000800004
PURPOSE: to assess the performance of lamellar body count compared to the shake (Clements) test in the prediction of fetal lung maturity in diabetics. METHODS: prospective study of 62 patients who underwent amniocentesis between the 26th and 39th week of pregnancy. Immediately after collection, the amniotic fluid sample was submitted to the shake test and lamellar body count. Deliveries occurred within three days of amniocentesis. Immature test results (absence of a complete bubble ring in the third tube for the shake test and less than 50,000 lamellar bodies) were confronted with the occurrence of pulmonary immaturity in the neonate (respiratory distress syndrome). The performance of both tests was compared using the chi2 test and p<0.05 was considered to be significant. RESULTS: seven infants had respiratory distress syndrome (11.3%). The lamellar body count and shake test were similar regarding sensitivity (100 vs 71.4%, respectively) and negative predictive value (100 vs 93.5%). Lamellar body count was superior as regards specificity (87.3 vs 52.7%, p=0.0001), positive predictive value (50 vs 16.1%, p=0.017), and accuracy (88.7 vs 54.8%, p<0.001). CONCLUSIONS: lamellar body count is a simple and accurate method of assessing fetal lung maturity. It performs slightly better than the shake test in terms of specificity, positive predictive value and accuracy, with the advantage of not requiring manipulation or reagents. Similar to the shake test, lamellar body count has a high-negative predictive value: mature results (50,000 or more) indicate thar the infant will not have hyaline membrane.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):419-423
DOI 10.1590/S0100-72032003000600006
PURPOSE: to evaluate the perinatal outcomes of pregnancies complicated by oligohydramnios, not due to premature rupture of membranes (PRM), diagnosed until the 26th week of gestation. PATIENTS AND METHODS: we analyzed retrospectively the cases of oligohydramnios that occurred from January 1994 to December 2000, and were diagnosed until the 26th week of gestation. Oligohydramnios was present when the amniotic fluid index was less or equal to 5.0 cm. After diagnosis the patients were followed-up with serial ultrasound evaluation, with emphasis on the maintenance of the oligohydramnios state. When remission of the oligohydramnios occurred, patients remained in the study. Cases due to PRM, fetal death detected on the first examination and the women who gave birth in another institution were excluded from the study. Concerning the patients, the presence of clinical and obstetric diseases was investigated. As regards the newborns, we evaluated birth weight, time of admission/death, occurrence of death or malformations. RESULTS: twenty-seven cases of oligohydramnios were analyzed. Thirteen fetuses had congenital anomalies, and among them, eight had anomalies of the urinary tract, four of the nervous system and one had cystic hygroma. Fourteen patients had a clinical or an obstetric disease, mainly hypertension (10 cases). In addition, we found three cases of placenta previa and one case of thyropathy. There were thirteen fetal deaths and fourteen neonatal deaths. CONCLUSION: oligohydramnios not due to PRM, occurring in the second trimester of gestation, independent of the etiology or the presence of congenital anomalies, was associated with a fatal perinatal result.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(6):419-423
DOI 10.1590/S0100-72032003000600006
PURPOSE: to evaluate the perinatal outcomes of pregnancies complicated by oligohydramnios, not due to premature rupture of membranes (PRM), diagnosed until the 26th week of gestation. PATIENTS AND METHODS: we analyzed retrospectively the cases of oligohydramnios that occurred from January 1994 to December 2000, and were diagnosed until the 26th week of gestation. Oligohydramnios was present when the amniotic fluid index was less or equal to 5.0 cm. After diagnosis the patients were followed-up with serial ultrasound evaluation, with emphasis on the maintenance of the oligohydramnios state. When remission of the oligohydramnios occurred, patients remained in the study. Cases due to PRM, fetal death detected on the first examination and the women who gave birth in another institution were excluded from the study. Concerning the patients, the presence of clinical and obstetric diseases was investigated. As regards the newborns, we evaluated birth weight, time of admission/death, occurrence of death or malformations. RESULTS: twenty-seven cases of oligohydramnios were analyzed. Thirteen fetuses had congenital anomalies, and among them, eight had anomalies of the urinary tract, four of the nervous system and one had cystic hygroma. Fourteen patients had a clinical or an obstetric disease, mainly hypertension (10 cases). In addition, we found three cases of placenta previa and one case of thyropathy. There were thirteen fetal deaths and fourteen neonatal deaths. CONCLUSION: oligohydramnios not due to PRM, occurring in the second trimester of gestation, independent of the etiology or the presence of congenital anomalies, was associated with a fatal perinatal result.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(2):109-114
DOI 10.1590/S0100-72032003000200006
PURPOSE: to evaluate maternal and perinatal outcomes of premature rupture of membranes up to the 26th week of gestation. METHODS: retrospective analysis of the cases of premature rupture of membranes up to the 26th week of gestation, without signs of labor or treatment for this condition before admission, followed up at the Obstetric Pathology Infirmary of the "Maternidade Escola Assis Chateaubriand", Federal University of Ceará, from January 1994 to December 1999. The cases with gestational age less than 22 weeks and birth weight lower than 500 g were excluded. Premature rupture of membranes was confirmed by sterile speculum examination. In doubt, amniotic fluid crystallization test and pH determination were performed. All pregnant women underwent ultrasound examination to determine gestational age and amniotic fluid volume. Data concerning the result of gestation and consequences for the mother, fetus and neonate were analyzed. RESULTS: a total of 29 cases of premature rupture of membranes fulfilled inclusion criteria. The mean gestational age at rupture of membranes was 22 weeks. The mean duration of the latency period was 21.7 days. There Were 22 spontaneous vaginal and 3 induced deliveries, besides 4 cesarean sections. In six pregnant women there were signs of infection before labor. Antibiotics were administered in 37.9% of the cases and corticosteroids in 6.9%. No patient underwent tocolysis. There were 3 fetal and 25 neonatal deaths. Only one infant survived. This child remained at the neonatal care unit for 19 days due to infection and respiratory distress syndrome. There was no maternal death. CONCLUSION: the premature rupture of membranes up to the 26th week of gestation has been a fatal discase for fetuses and newborns in our institution.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(2):109-114
DOI 10.1590/S0100-72032003000200006
PURPOSE: to evaluate maternal and perinatal outcomes of premature rupture of membranes up to the 26th week of gestation. METHODS: retrospective analysis of the cases of premature rupture of membranes up to the 26th week of gestation, without signs of labor or treatment for this condition before admission, followed up at the Obstetric Pathology Infirmary of the "Maternidade Escola Assis Chateaubriand", Federal University of Ceará, from January 1994 to December 1999. The cases with gestational age less than 22 weeks and birth weight lower than 500 g were excluded. Premature rupture of membranes was confirmed by sterile speculum examination. In doubt, amniotic fluid crystallization test and pH determination were performed. All pregnant women underwent ultrasound examination to determine gestational age and amniotic fluid volume. Data concerning the result of gestation and consequences for the mother, fetus and neonate were analyzed. RESULTS: a total of 29 cases of premature rupture of membranes fulfilled inclusion criteria. The mean gestational age at rupture of membranes was 22 weeks. The mean duration of the latency period was 21.7 days. There Were 22 spontaneous vaginal and 3 induced deliveries, besides 4 cesarean sections. In six pregnant women there were signs of infection before labor. Antibiotics were administered in 37.9% of the cases and corticosteroids in 6.9%. No patient underwent tocolysis. There were 3 fetal and 25 neonatal deaths. Only one infant survived. This child remained at the neonatal care unit for 19 days due to infection and respiratory distress syndrome. There was no maternal death. CONCLUSION: the premature rupture of membranes up to the 26th week of gestation has been a fatal discase for fetuses and newborns in our institution.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(4):225-232
DOI 10.1590/S0100-72032001000400005
Purpose: to determine the amniotic fluid index (AFI) through ultrasound assessment in normal pregnancies and produce a curve of normalcy for the AFI from the 12th up to the 42nd week of pregnancy. Methods: the study involved 471 measurements on 256 pregnant women, all undergoing normal pregnancies. In pregnancies of more than 20 weeks an estimation was made of the sum of the largest vertical diameters of the amniotic fluid pockets in the four quadrants into which the uterus was divided. In the pregnancies of 20 weeks or less, the sum was obtained from the largest vertical diameters measured in the two halves into which the uterus was divided. Results were expressed in centimeters. Results: AFI was measured (471 measurements) and the results were stratified and grouped by weeks of pregnancy (every two weeks), except the 12th week which was analyzed alone. From an average of 4.7 cm (limits 3.8-5.9 for the 5th and the 95th percentiles) at the 12th week of pregnancy, the AFI grew progressively up to the maximum mean of 14.6 cm at the 32nd week (limits: 7.0-2.5 cm). AFI presented stable measurements from the 21st up to the 40th week. After that, AFI measurements suffered a sharp decrease. The AFI cutoff point occurred at the 21st week of pregnancy. The percent increase of AFI obtained at the 32nd week, when compared to the 12th was 197.7%, and 2.9% at the end of pregnancy when compared to the measurement of the week taken as reference. Conclusion: AFI varied during pregnancy. It increased progressively up to the 21st week and then stabilized up to the 40th week. After that, it experienced a sharp decline. The maximum measurement of the AFI occurred at the 32nd week. By establishing a normalcy curve for AFI it becomes easier to detect changes and allows for a better follow-up of the pregnancy period.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(4):225-232
DOI 10.1590/S0100-72032001000400005
Purpose: to determine the amniotic fluid index (AFI) through ultrasound assessment in normal pregnancies and produce a curve of normalcy for the AFI from the 12th up to the 42nd week of pregnancy. Methods: the study involved 471 measurements on 256 pregnant women, all undergoing normal pregnancies. In pregnancies of more than 20 weeks an estimation was made of the sum of the largest vertical diameters of the amniotic fluid pockets in the four quadrants into which the uterus was divided. In the pregnancies of 20 weeks or less, the sum was obtained from the largest vertical diameters measured in the two halves into which the uterus was divided. Results were expressed in centimeters. Results: AFI was measured (471 measurements) and the results were stratified and grouped by weeks of pregnancy (every two weeks), except the 12th week which was analyzed alone. From an average of 4.7 cm (limits 3.8-5.9 for the 5th and the 95th percentiles) at the 12th week of pregnancy, the AFI grew progressively up to the maximum mean of 14.6 cm at the 32nd week (limits: 7.0-2.5 cm). AFI presented stable measurements from the 21st up to the 40th week. After that, AFI measurements suffered a sharp decrease. The AFI cutoff point occurred at the 21st week of pregnancy. The percent increase of AFI obtained at the 32nd week, when compared to the 12th was 197.7%, and 2.9% at the end of pregnancy when compared to the measurement of the week taken as reference. Conclusion: AFI varied during pregnancy. It increased progressively up to the 21st week and then stabilized up to the 40th week. After that, it experienced a sharp decline. The maximum measurement of the AFI occurred at the 32nd week. By establishing a normalcy curve for AFI it becomes easier to detect changes and allows for a better follow-up of the pregnancy period.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(6):401-406
DOI 10.1590/S0100-72032002000600007
Purpose: to evaluate, in the high-risk pregnancies with oligohydramnios, the assessment tools for fetal well-being and perinatal results. Methods: five hundred seventy-two high-risk pregnancies were retrospectively analyzed. All of them presented with oligohydramnios established by AFI <=5.0 cm. Severe oligohydramnios was detected in 220 cases (AFI<=3,0 cm). The fetal well-being tests included: antepartum cardiotocography, biophysical profile score (BPS) and dopplervelocimetry of umbilical and middle cerebral arteries. Multiple gestation, fetal anomalies and premature rupture of membrane cases were excluded. Results: severe oligohydramnios was significantlly associated with abnormal and suspected cardiotocography results (23.2%), abnormal biophysical profile score (10.5%), abnormal results of middle cerebral artery dopplervelocimetry (54.5%), small for gestational age infants (32.7%) and meconial amniotic fluid (27.9%) when compared to pregnancies with AFI between 3.1 and 5.0 cm. This group presented: abnormal or suspected cardiotocography results (13.9%), abnormal biophysical profile score (4.3%), abnormal results of middle cerebral artery dopplervelocimetry (33.9%), small for gestational age infants (21.0%) and meconial amniotic fluid (16.8%). Conclusion: the oligohydramnios severity in high-risk pregnancies allows to discriminate the cases that are related to adverse perinatal outcome.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(6):401-406
DOI 10.1590/S0100-72032002000600007
Purpose: to evaluate, in the high-risk pregnancies with oligohydramnios, the assessment tools for fetal well-being and perinatal results. Methods: five hundred seventy-two high-risk pregnancies were retrospectively analyzed. All of them presented with oligohydramnios established by AFI <=5.0 cm. Severe oligohydramnios was detected in 220 cases (AFI<=3,0 cm). The fetal well-being tests included: antepartum cardiotocography, biophysical profile score (BPS) and dopplervelocimetry of umbilical and middle cerebral arteries. Multiple gestation, fetal anomalies and premature rupture of membrane cases were excluded. Results: severe oligohydramnios was significantlly associated with abnormal and suspected cardiotocography results (23.2%), abnormal biophysical profile score (10.5%), abnormal results of middle cerebral artery dopplervelocimetry (54.5%), small for gestational age infants (32.7%) and meconial amniotic fluid (27.9%) when compared to pregnancies with AFI between 3.1 and 5.0 cm. This group presented: abnormal or suspected cardiotocography results (13.9%), abnormal biophysical profile score (4.3%), abnormal results of middle cerebral artery dopplervelocimetry (33.9%), small for gestational age infants (21.0%) and meconial amniotic fluid (16.8%). Conclusion: the oligohydramnios severity in high-risk pregnancies allows to discriminate the cases that are related to adverse perinatal outcome.
