Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Research Article

Comparison of Amniotic Fluid Index and Single Deepest Vertical Pocket

Author(s): Roopa Padavagodu Shivananda*, Rekha Anbu, Shubha Rao, Nivedita Hegde, Anjali Suneel Mundkur and Shripad Hebbar

Volume 18, Issue 2, 2022

Published on: 23 February, 2021

Article ID: e221121191751 Pages: 7

DOI: 10.2174/1573404817666210223162752

Price: $65

Open Access Journals Promotions 2
Abstract

Background: The best method of estimation of amniotic fluid volume is a matter of ongoing debate.

Objectives: To determine the perinatal & maternal outcomes in pregnant patients when the amniotic fluid volume was assessed by the Amniotic Fluid Index (AFI) in comparison to the Single Deepest Vertical Pocket (SDVP).

Methods: We studied abnormal cardiotocograph, meconium stained amniotic fluid, birth weight < 2.5 kg, Apgar score at 5 min < 7, cord blood pH < 7.2 & necessity for NICU admission as perinatal outcomes. Rate of diagnosis of oligohydramnios, induction of labor for oligohydramnios & mode of delivery were observed in maternal outcomes.

Results: Of the 697 pregnant patients recruited, 353 were in the AFI and 344 in the SDVP group. Perinatal outcomes were similar in both. In the AFI group, the number of women diagnosed with oligohydramnios was higher (p = 0.0333) & the rate of induction was also higher (p = 0.003378). Vaginal deliveries were more in the SDVP group. The Receiver Operating Characteristic curves showed statistically significant correlation with NICU stay, birth-weight, and mode of delivery. While an AFI of > 5 cm and SDVP of > 1.9 cm had good sensitivity in predicting babies with a birth weight of ≥ 2.5 kg and avoiding NICU admissions, an AFI of > 5.8 cm and an SDVP of > 1.9 cm had a sensitivity of around 80% in predicting successful vaginal deliveries.

Conclusion: The SDVP method has a slight edge over the AFI in terms of lower inductions and higher vaginal deliveries with comparable perinatal outcomes.

Keywords: AFI, SDVP, AFV, high-risk pregnancy, perinatal outcomes, maternal outcomes.

Graphical Abstract
[1]
Emily DF, Tushar B. Embryology, Amniotic Fluid. Treasure Island: StatPearls Publishing 2021. https://www.ncbi.nlm.nih.gov/books/NBK541089/
[2]
Ten BCMA, Bots J, Varela-Lasheras I, Bugiani M, Galis F, Van DS. Amniotic fluid deficiency and congenital abnormalities both influence fluctuating asymmetry in developing limbs of human deceased fetuses. PLoS One 2013; 8(11): e81824.
[3]
Rainford M, Adair R, Scialli AR, Ghidini A, Spong CY. Amniotic fluid index in the uncomplicated term pregnancy. Prediction of outcome. J Reprod Med 2011; 46(6): 589-92.https://pubmed.ncbi.nlm.nih.gov/11441685/
[4]
Gilbert WM, Brace RA. Amniotic fluid volume and normal flows to and from the amniotic cavity. Semin Perinatol 1993; 17: 150-7.https://europepmc.org/article/med/8378799
[5]
Ross MG, Nijland MJM. Fetal swallowing: Relation to amniotic fluid regulation. Clin Obstet Gynecol 1997; 40(2): 352-65.https://pubmed.ncbi.nlm.nih.gov/9199846/
[6]
Dubil EA, Magann EF. Amniotic fluid as a vital sign for fetal wellbeing. Australas J Ultrasound Med 2013; 16(2): 62-70.
[http://dx.doi.org/10.1002/j.2205-0140.2013.tb00167.x]
[7]
Sandlin AT, Chauhan SP, Magann EF. Clinical relevance of sonographically estimated amniotic fluid volume. J Ultrasound Med 2013; 32(5): 851-63.
[8]
Baschat AA. Fetal responses to placental insufficiency: an update. BJOG 2004; 111(10): 1031-41.
[http://dx.doi.org/10.1111/j.1471-0528.2004.00273.x] [PMID: 15383103]
[9]
Rabie N, Magann E, Steelman S, Ounpraseuth S. Oligohydramnios in complicated and uncomplicated pregnancy: a systematic review and meta-analysis. Ultrasound Obstet Gynecol 2017; 49(4): 442-9.
[http://dx.doi.org/10.1002/uog.15929] [PMID: 27062200]
[10]
Manning FA. Dynamic ultrasound-based fetal assessment: The fetal biophysical profile score. Clin Obstet Gynecol 1995; 38(1): 26-44.https://pubmed.ncbi.nlm.nih.gov/7796550/
[http://dx.doi.org/10.1097/00003081-199503000-00006]
[11]
Goldstein RB, Filly RA. Sonographic estimation of amniotic fluid volume. Subjective assessment versus pocket measurements. J Ultrasound Med 1988; 7(7): 363-9.
[http://dx.doi.org/10.7863/jum.1988.7.7.363] [PMID: 3043015]
[12]
Kilpatrick SJ, Safford KL, Pomeroy T, Hoedt L, Scheerer L, Laros RK. Maternal hydration increases amniotic fluid index. Obstet Gynecol 1991; 78(6): 1098-102.
[PMID: 1945215]
[13]
Nabhan AF, Abdelmoula YA. Amniotic fluid index versus single deepest vertical pocket as a screening test for preventing adverse pregnancy outcome. Cochrane Database Syst Rev 2008; 2008(3): CD006593.
[http://dx.doi.org/10.1002/14651858.CD006593.pub2]
[14]
Nabhan AF, Abdelmoula YA. Amniotic fluid index versus single deepest vertical pocket: a meta-analysis of randomized controlled trials. Int J Gynaecol Obstet 2009; 104(3): 184-8.
[http://dx.doi.org/10.1016/j.ijgo.2008.10.018] [PMID: 19046586]
[15]
Fok WY, Chan LY, Lau TK. The influence of fetal position on amniotic fluid index and single deepest pocket. Ultrasound Obstet Gynecol 2006; 28(2): 162-5.
[http://dx.doi.org/10.1002/uog.2802] [PMID: 16708416]
[16]
Phelan JP, Smith CV, Broussard P, Small M. Amniotic fluid volume assessment with the four-quadrant technique at 36-42 weeks’ gestation. J Reprod Med 1987; 32(7): 540-2.
[PMID: 3305930]
[17]
Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. Am J Obstet Gynecol 1984; 150(3): 245-9.
[http://dx.doi.org/10.1016/S0002-9378(84)90359-4] [PMID: 6385713]
[18]
Bhat RA, Kushtagi P. A re-look at the duration of human pregnancy. Singapore Med J 2006; 47(12): 1044-8.
[PMID: 17139400]
[19]
Manning FA, Snijders R, Harman CR, Nicolaides K, Menticoglou S, Morrison I. Fetal biophysical profile score. VI. Correlation with antepartum umbilical venous fetal pH. Am J Obstet Gynecol 1993; 169(4): 755-63.
[http://dx.doi.org/10.1016/0002-9378(93)90002-Z] [PMID: 8238129]
[20]
Freeman RK, Anderson G, Dorchester W. A prospective multi-institutional study of antepartum fetal heart rate monitoring. I. Risk of perinatal mortality and morbidity according to antepartum fetal heart rate test results. Am J Obstet Gynecol 1982; 143(7): 771-7.
[http://dx.doi.org/10.1016/0002-9378(82)90008-4] [PMID: 7102744]
[21]
Kehl S, Schelkle A, Thomas A, et al. Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol 2016; 47(6): 674-9.
[http://dx.doi.org/10.1002/uog.14924] [PMID: 26094600]
[22]
Moses J, Doherty DA, Magann EF, Chauhan SP, Morrison JC. A randomized clinical trial of the intrapartum assessment of amniotic fluid volume: Amniotic fluid index versus the single deepest pocket technique.American J Obstet Gynecol Mosby Inc 2004; 190(6): 1564-9.
[http://dx.doi.org/10.1016/j.ajog.2004.03.046]
[23]
Mukhopadhyay B, Ahmad SN, Agarwal S, Kabra SL. Evaluation of feto-maternal outcome using AFI and SDVP for amniotic fluid assessment; Which is a better method? Int J Reprod Contracept Obstet Gynecol 2017; 6(7): 3109.
[http://dx.doi.org/10.18203/2320-1770.ijrcog20172943]
[24]
Rosati P, Guariglia L, Cavaliere AF, et al. A comparison between amniotic fluid index and the single deepest vertical pocket technique in predicting adverse outcome in prolonged pregnancy. J Prenat Med 2015; 9(1-2): 12-5.
[http://dx.doi.org/10.11138/jpm/2015.9.1.012] [PMID: 26918093]
[25]
Magann EF, Nevils BG, Chauhan SP, Whitworth NS, Klausen JH, Morrison JC. Low amniotic fluid volume is poorly identified in singleton and twin pregnancies using the 2 x 2 cm pocket technique of the biophysical profile. South Med J 1999; 92(8): 802-5.
[http://dx.doi.org/10.1097/00007611-199908000-00011] [PMID: 10456720]
[26]
Magann EF, Chauhan SP, Sanderson M, McKelvey S, Dahlke JD, Morrison JC. Amniotic fluid volume in normal pregnancy: comparison of two different normative datasets. J Obstet Gynaecol Res 2012; 38(2): 364-70.
[http://dx.doi.org/10.1111/j.1447-0756.2011.01710.x] [PMID: 22175279]
[27]
Magann EF, Ounpraseuth S, Chauhan SP, et al. Correlation of ultrasound estimated with dye-determined or directly measured amniotic fluid volume revisited. Gynecol Obstet Invest 2015; 79(1): 46-9.
[http://dx.doi.org/10.1159/000365088] [PMID: 25196449]
[28]
Magann EF, Chauhan SP, Barrilleaux PS, Whitworth NS, Martin JN. Amniotic fluid index and single deepest pocket: weak indicators of abnormal amniotic volumes. Obstet Gynecol 2000; 96(5 Pt 1): 737-40.
[http://dx.doi.org/10.1097/00006250-200011000-00017] [PMID: 11042310]
[29]
Dildy GA III, Lira N, Moise KJ Jr, Riddle GD, Deter RL. Amniotic fluid volume assessment: comparison of ultrasonographic estimates versus direct measurements with a dye-dilution technique in human pregnancy. Am J Obstet Gynecol 1992; 167: 986-94.
[http://dx.doi.org/10.1016/S0002-9378(12)80025-1] [PMID: 1415438]
[30]
Madendag Y, Madendag IC, Sahin E, Aydin E, Sahin ME, Acmaz G. How well do the popular ultrasonic techniques estimate amniotic fluid volume and diagnose oligohydramnios, in Fact? Ultrasound Q 2019; 35(1): 35-8.
[http://dx.doi.org/10.1097/RUQ.0000000000000408] [PMID: 30601443]
[31]
Magann EF, Doherty DA, Field K, Chauhan SP, Muffley PE, Morrison JC. Biophysical profile with amniotic fluid volume assessments. Obstet Gynecol 2004; 104(1): 5-10.
[http://dx.doi.org/10.1097/01.AOG.0000131618.14176.00] [PMID: 15228994]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy