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A diminished intrapartum amniotic fluid index is a predictive marker of possible adverse neonatal outcome when associated with prolonged labor.

Abstract：

OBJECTIVE:To determine whether a diminished intrapartum amniotic fluid volume represents a risk of adverse neonatal outcome when it occurs in conjunction with prolonged labor. METHODS:The intrapartum amniotic fluid index (iAFI) was measured in 242 parturients over 35 weeks of gestation during 1st-stage labor, and the umbilical artery blood gas was analyzed at delivery. The subjects were divided into group A (n = 99), having a diminished amniotic fluid volume (iAFI < or = 8.0 cm) and group B (n = 143), having a normal amniotic fluid volume (iAFI 8.1-20.0 cm), and selected antenatal, delivery, and neonatal variables were compared. In addition, the two groups were subdivided according to the duration of labor. Statistical analysis was performed using independent Student's t test, Mann-Whitney U test, chi-square analysis, and Fisher's exact test where appropriate. p < 0.05 was considered significant. RESULTS:The patient characteristics and pregnancy outcomes were similar in groups A and B, as were the incidences of an umbilical artery blood pH <7.20 and/or an Apgar score <7 (group A 9.5%, group B 10.1%). In group A, however, the incidence of an adverse neonatal outcome was 23.5% in cases in whom the duration of labor was longer than 8 h which was significantly higher than in cases in whom the duration of labor was 8 h or less (2.8%; p < 0.01). In group B, the incidence of an adverse neonatal outcome was similar in the two subgroups. CONCLUSIONS:The risk of an adverse neonatal outcome is higher in patients with diminished amniotic fluid volume if labor is prolonged. Consequently, determination of the iAFI could be a useful admission test.

journal_name

Gynecol Obstet Invest

journal_title

Gynecologic and obstetric investigation

authors

Kawasaki N,Nishimura H,Yoshimura T,Okamura H

doi

10.1159/000049402

keywords:

subject

Has Abstract

pub_date

2002-01-01 00:00:00

pages

1-5

issue

1

eissn

0378-7346

issn

1423-002X

pii

goi53001

journal_volume

53

pub_type

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