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The relationship between amniotic fluid index and successful external cephalic version: a 14-year experience
Marc Boucher1, Emmanuel Bujold, Gérald P Marquette
1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec, Canada. boucherhsj@aol.com
American Journal of Obstetrics and Gynecology
|October 4, 2003
Summary
A higher amniotic fluid index (AFI) correlates with increased external cephalic version (ECV) success rates and influences cesarean delivery rates in nulliparous women. This finding aids in patient counseling before ECV procedures.
Area of Science:
- Maternal-Fetal Medicine
- Obstetrics
- Perinatology
Background:
- External cephalic version (ECV) is a procedure to turn a breech fetus to a cephalic presentation.
- The role of amniotic fluid volume in ECV success and obstetric outcomes requires further elucidation.
Purpose of the Study:
- To evaluate the association between amniotic fluid index (AFI) and the success of external cephalic version (ECV).
- To assess the impact of AFI on obstetric outcomes, including cesarean delivery rates, in patients undergoing ECV.
Main Methods:
- A prospective observational study included 1361 patients undergoing ECV between 1987 and 2000.
- Patients were stratified into three groups based on pre-ECV AFI: <10 cm, 10-15 cm, and >15 cm.
- Success rates, fetal heart rate decelerations, and cesarean delivery rates were analyzed in relation to AFI.
Main Results:
- ECV success rates significantly increased with higher AFI in both parous and nulliparous women (P<.001).
- Cesarean delivery rates were associated with AFI in nulliparous women (P<.001) but not in multiparous women.
- Prolonged fetal heart rate decelerations were not significantly related to AFI.
Conclusions:
- Amniotic fluid volume, as measured by AFI, is a significant factor influencing successful ECV.
- AFI impacts the likelihood of cesarean delivery, particularly in nulliparous patients.
- These findings are valuable for informed consent and patient counseling prior to attempting ECV.