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Prediction of small for gestational age newborns using ultrasound estimated and actual amniotic fluid volume: Published data revisited
Author(s) -
CHAUHAN Suneet P.,
MAGANN Everett F.,
DOHERTY Dorota A.,
ENNEN Christopher S.,
NIEDERHAUSER Amy,
MORRISON John C.
Publication year - 2008
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2008.00830.x
Subject(s) - amniotic fluid , volume (thermodynamics) , gestational age , obstetrics , ultrasound , medicine , pregnancy , fetus , physics , biology , radiology , genetics , quantum mechanics
Background: Intrauterine growth restriction (IUGR) is a complex problem in modern obstetrics. The presence of oligohydramnios is reported as an important diagnostic and prognostic factor in the management of a pregnancy complicated by IUGR. Aim: To determine the predictive accuracy of sonographic and actual amniotic fluid volume (AFV) to identify small for gestational age (SGA; birthweight < 10%). Methods: Before amniocentesis, the single deepest pocket (SDP) and amniotic fluid index (AFI) were obtained. The AFV was determined using a diazo‐dye reaction. Thresholds for AFI, SDP and AFV were estimated using receiver‐operating curves analysis and areas under the curves were used to assess predictive accuracy of these indices. Likelihood ratios (LR) were obtained. Results: Among the 175 newborns, 16% had SGA. Compared to newborns with birthweight > 10%, all AFV indices were significantly lower ( P = 0.001, P = 0.001 and P = 0.009 for AFI, SDP and AFV respectively) for SGA. The areas under the curves for all curves < 0.65 and the LR for all thresholds were < 5.0, reflecting poor diagnostic capabilities. Conclusions: Despite observed lower AFV indices in SGA, neither sonographic examination nor determination of AFV is a reliable predictor of suboptimal growth.