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Isolated low-normal amniotic fluid volume in the early third trimester: association with adverse perinatal outcomesa

  • Kazumasa Hashimoto EMAIL logo , Tania Kasdaglis , Sheveta Jain , Kristin Atkins , Chris R. Harman and Ahmet A. Baschat
Published/Copyright: December 8, 2012
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 41 Issue 4

Abstract

Aims: To test if an isolated finding of low-normal amniotic fluid index (AFI) in the early third trimester in low-risk patients is associated with adverse perinatal outcomes.

Methods: Retrospective cohort study with uncomplicated singleton pregnancies that had ultrasound studies between 28.0 and 31.9 weeks’ gestation. Two cohorts with AFI 8.0–11.9 cm (low-normal, LN) and AFI 12.0–19.9 cm (mid-normal, MN) were compared.

Results: Patients with LN-AFI (n=99) were more likely to have early (<34 weeks) and late (<37 weeks) preterm birth (PTB) (relative risk 4.2 and 2.4, respectively) and a small for gestational age (SGA) infant (relative risk 1.8) than MN-AFI (n=834), corresponding to a higher NICU admission rate (relative risk 2.5). The risk of “spontaneous” PTB (preterm labor and rupture of membranes) did not differ between the cohorts, whereas the risk of “indicated” PTB (maternal or fetal indications) was significantly increased in LN-AFI. The incidence of abnormal antepartum testing, stillbirth, preeclampsia, placental abruption, fetal intolerance to labor, emergency cesarean delivery, umbilical artery pH <7.0, Apgar scores <7 at 5 min, and neonatal death was not increased in patients with LN-AFI.

Conclusion: Low-normal AFI in the early third trimester increases the risk for subsequent delivery of an SGA infant and indicated PTB.

Keywords: Amniotic fluid index; low-normal AFI; perinatal outcome; third trimester
Corresponding author: Kazumasa Hashimoto, MD, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, USA
  1. a

    The results of the study were, in part, presented at the 31st Annual Meeting of the Society for Maternal-Fetal Medicine, San Francisco, CA, February 7–12, 2011 and at the 21st World Congress on Ultrasound in Obstetrics and Gynecology, Los Angeles, CA, September 18–22, 2011.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2012-6-4
Accepted: 2012-11-6
Published Online: 2012-12-08
Published in Print: 2013-07-01

©2013 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/jpm-2012-0130
Keywords for this article
Amniotic fluid index; low-normal AFI; perinatal outcome; third trimester

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Review article
  4. Anxious and depressive components of Edinburgh Postnatal Depression Scale in maternal postpartum psychological problems1)
  5. Original Articles – Obstetrics
  6. Isolated low-normal amniotic fluid volume in the early third trimester: association with adverse perinatal outcomesa
  7. Trends in twin pregnancies and mode of delivery during the last 30 years: inconsistency between guidelines and clinical practice
  8. Prenatal care in adult women exposed to childhood sexual abuse
  9. Maternal and fetal adropin levels in gestational diabetes mellitus
  10. Ethnic disparities in perinatal mortality at 40 and 41 weeks of gestation
  11. Polymorphisms in the activin A receptor type 2A gene affect the onset time and severity of preeclampsia in the Turkish population
  12. Outcome of isolated fetal renal pyelectasis diagnosed during midtrimester screening ultrasound and cut-off value to predict a persistent or progressive pyelectasis in utero
  13. A polymorphism in an autophagy-related gene, ATG16L1, influences time to delivery in women with an unfavorable cervix who require labor induction
  14. Management of gestational hypertension – the impact of HYPITATa
  15. Reliability of quantitative elastography of the uterine cervix in at-term pregnancies
  16. Congenital anomalies, prematurity, and low birth weight rates in relation to nuclear power plant proximity1)
  17. Original Articles – Fetus
  18. Fetal magnetic resonance imaging of lymphangiomas
  19. Original Articles – Newborn
  20. Brainstem dysgenesis during the neonatal period: diagnosis and management
  21. Improving admission temperature in extremely low birth weight infants: a hospital-based multi-intervention quality improvement project
  22. Short Communication
  23. Periconceptional use of folic acid and risk of miscarriage – findings of the Oral Cleft Prevention Program in Brazil
  24. Congress Calendar
  25. Congress Calendar
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