Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial)

• Verfasst von: Kehl, Sven [VerfasserIn]
• Verfasst von: Schelkle, Anika Luise [VerfasserIn]
• Verfasst von: Tuschy, Benjamin [VerfasserIn]
• Verfasst von: Berlit, Sebastian [VerfasserIn]
• Verfasst von: Weiß, Christel [VerfasserIn]
• Verfasst von: Sütterlin, Marc [VerfasserIn]
• Titel: Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial)
• Titelzusatz: a multicenter, open-label, randomized controlled trial
• Verf.angabe: S. Kehl, A. Schelkle, A. Thomas, A. Puhl, K. Meqdad, B. Tuschy, S. Berlit, C. Weiss, C. Bayer, J. Heimrich, U. Dammer, E. Raabe, M. Winkler, F. Faschingbauer, M.W. Beckmann and M. Sütterlin
• Jahr: 2016
• Jahr des Originals: 2015
• Umfang: 6 S.
• Fussnoten: Gesehen am 18.06.2019 ; First published: 10 June 2015
• Titel Quelle: Enthalten in: Ultrasound in obstetrics & gynecology
• Ort Quelle: New York, NY [u.a.] : Wiley, 1991
• Jahr Quelle: 2016
• Band/Heft Quelle: 47(2016), 6, Seite 674-679
• ISSN Quelle: 1469-0705
• DOI: doi:10.1002/uog.14924
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: AFI
• Sach-SW: amniotic fluid index
• Sach-SW: amniotic fluid volume
• Sach-SW: labor induction
• Sach-SW: oligohydramnios
• Sach-SW: perinatal outcome
• Sach-SW: SDP
• Sach-SW: single deepest pocket
• K10plus-PPN: 1667628836

Abstract

Objective To determine whether the amniotic fluid index (AFI) or the single deepest vertical pocket (SDP) technique for estimating amniotic fluid volume is superior for predicting adverse pregnancy outcome. Methods This was a multicenter randomized controlled trial including 1052 pregnant women with a term singleton pregnancy across four hospitals in Germany. Women were assigned randomly, according to a computer-generated allocation sequence, to AFI or SDP measurement for estimation of amniotic fluid volume. Oligohydramnios was defined as AFI ≤ 5 cm or the absence of a pocket measuring at least 2 × 1 cm. The diagnosis of oligohydramnios was followed by labor induction. The primary outcome measure was postpartum admission to a neonatal intensive care unit. Further outcome parameters were the rates of diagnosis of oligohydramnios and induction of labor (for oligohydramnios or without specific indication), and mode of delivery. Results Postpartum admission to a neonatal intensive care unit was similar between groups (4.2% (n = 21) vs 5.0% (n = 25); relative risk (RR), 0.85 (95% CI, 0.48-1.50); P = 0.57). In the AFI group, there were more cases of oligohydramnios (9.8% (n = 49) vs 2.2% (n = 11); RR, 4.51 (95% CI, 2.2-8.57); P < 0.01) and more cases of labor induction for oligohydramnios (12.7% (n = 33) vs 3.6% (n = 10); RR, 3.50 (95% CI, 1.76-6.96); P < 0.01) than in the SDP group. Moreover, an abnormal cardiotocography was seen more often in the AFI group than in the SDP group (32.3% (n = 161) vs 26.2% (n = 132); RR, 1.23 (95% CI, 1.02-1.50); P = 0.03). The other outcome measures were not significantly different between the two groups. Conclusions Use of the AFI method increased the rate of diagnosis of oligohydramnios and labor induction for oligohydramnios without improving perinatal outcome. The SDP method is therefore the favorable method to estimate amniotic fluid volume, especially in a population with many low-risk pregnancies. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.