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Amniotic fluid index and prolonged antepartum fetal heart rate decelerations
1Department of Obstetrics and Gynecology, University of Southern California, Los Angeles.
Abstract:
Both prolonged fetal heart rate (FHR) decelerations and decreased amounts of amniotic fluid (AF) have been associated with adverse fetal outcome. To determine whether adverse outcome could be predicted by a quantitative assessment of AF in patients with prolonged FHR decelerations, we identified 97 consecutive pregnancies found during antepartum testing to have prolonged FHR decelerations. A four-quadrant AF index was measured concurrently in 92 of these 97 patients. Women with an AF index less than 2 cm had operative intervention for fetal distress in seven of 11 cases (64%), compared with 17 of 81 (21%) who had an index of 2 cm or more (P = .005). We conclude that in patients with a prolonged FHR deceleration during antepartum testing, the need for operative intervention for fetal distress is increased when oligohydramnios is present.