Open AccessPresence of amniotic fluid sludge and pregnancy outcomes: A systematic review
Author(s) -
Pergialiotis Vasilios,
Bellos Ioannis,
Antsaklis Aris,
Loutradis Dimitrios,
Daskalakis George
Publication year - 2020
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13893
Subject(s) - medicine , obstetrics , pregnancy , observational study , gestational age , confounding , population , randomized controlled trial , relative risk , pessary , neonatal intensive care unit , cervical cerclage , incidence (geometry) , meta analysis , pediatrics , surgery , confidence interval , environmental health , optics , biology , genetics , physics
Several studies acknowledge that the presence of amniotic fluid sludge (AFS) is an independent predictive factor for preterm birth. In the present systematic review, we summarize research that focuses on the comparison of pregnancy outcomes among women with and without AFS. Material and methods Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar databases were systematically searched from inception. Both observational and randomized controlled studies were considered eligible provided that they reported data on pregnancy outcomes among women with and without AFS. Outcomes were not meta‐analyzed because of the high heterogeneity in terms of selected population and outcome reporting. Results Seventeen studies of 2432 women were included in this review. Six studies evaluated women at high risk for preterm birth. Pregnancies complicated by AFS had a lower gestational age at delivery and increased incidence of preterm delivery at <37 weeks. Neonatal death rates and admission to the Neonatal Intensive Care Unit were also increased. Evidence in low‐risk women, those with signs of preterm labor, in those carrying twins, and in women with cervical cerclage or Arabin pessary was extremely limited. Conclusions Women with AFS seem to deliver at an earlier gestational age, and preterm birth rates are also increased. Limited data seem to point to neonatal morbidity and mortality being increased. However, the presence of a direct association should not be assumed because the evidence is not adjusted for the presence of confounders.