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Determination of amniotic fluid volume in twin pregnancies: ultrasonographic evaluation versus operator estimation
E F Magann1, S P Chauhan, N S Whitworth
1Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Objective:
We sought to determine the accuracy of amniotic fluid volume estimation (visually) in diamniotic twin pregnancy versus ultrasonography techniques.
Study Design:
In this prospective study the volume of each sac in 23 sets of diamniotic twin pregnancies was subjectively and objectively estimated by a second-year obstetric resident, nurse sonographer, maternal-fetal medicine fellow, and maternal-fetal medicine staff. The actual volume was confirmed by amniocentesis and a dye-dilution technique.
Results:
There was no difference in the total number of correct estimates of volume by level of operator experience (P =.98), ultrasonography technique (P =.87), or combined subjective versus objective correct estimates (P =.87). Identification of low volume was not different among the four evaluators (P =.48), but the percentage of correct estimates was poor (7%-29%). The 2-diameter pocket was a better predictor of oligohydramnios (57%) than the amniotic fluid index or the largest vertical pocket (12.5%; P =.002).
Conclusion:
The extremes of volume (low or high) are poorly identified by the subjective or objective assessment of volume.