Perinatal outcome and amniotic fluid index in the antepartum and intrapartum periods: A meta-analysis.

Chauhan SP, Sanderson M, Hendrix NW, Magann EF, Devoe LD
Am J Obstet Gynecol. 1999 181 (6): 1473-8

PMID: 10601931 · DOI:10.1016/s0002-9378(99)70393-5

OBJECTIVE - Our purpose was to perform a meta-analysis of studies on the risks of cesarean delivery for fetal distress, 5-minute Apgar score <7, and umbilical arterial pH <7.00 in patients with antepartum or intrapartum amniotic fluid index >5.0 or <5.0 cm.

STUDY DESIGN - Using a MEDLINE search, we reviewed all studies published between 1987 and 1997 that correlated antepartum or intrapartum amniotic fluid index with adverse peripartum outcomes. The inclusion criteria were studies in English that associated at least one of the selected adverse outcomes with an amniotic fluid index of 5.0 cm. Contingency tables were constructed for each study, and relative risks and standard errors of their logs were calculated. Fixed-effects pooled relative risks were calculated for groups of studies that were homogeneous, whereas random-effects pooled relative risks were calculated for significantly heterogeneous groups of studies.

RESULTS - Eighteen reports describing 10,551 patients met our inclusion criteria. An antepartum amniotic fluid index of 5.0 cm, is associated with an increased risk of cesarean delivery for fetal distress (pooled relative risk, 2.2; 95% confidence interval, 1.5-3.4) and an Apgar score of <7 at 5 minutes (pooled relative risk, 5.2; 95% confidence interval, 2.4-11.3). An intrapartum amniotic fluid index of
CONCLUSIONS - An antepartum or intrapartum amniotic fluid index of

MeSH Terms (16)

Acidosis Amniotic Fluid Apgar Score Cesarean Section Female Fetal Blood Fetal Distress Humans Hydrogen-Ion Concentration Incidence Infant, Newborn Predictive Value of Tests Pregnancy Pregnancy Outcome Risk Factors Ultrasonography, Prenatal

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