INTRAPARTUM AMNIOTIC-FLUID INDEX - A POOR DIAGNOSTIC-TEST FOR ADVERSEPERINATAL OUTCOME

OBJECTIVE: To determine if an intrapartum amniotic fluid index (IAFI) less than or equal to 5.0 cm, or any other level, is associated with a bdominal delivery for fetal intolerance to labor or Apgar scores <7 at one and five minutes. STUDY DESIGN: Prospectively, MFI was obtained i n the latent phase of labor on 1,000 parturients at >26 weeks. Receive r operating characteristic curves were utilized to determine if any IA FI could be utilized to predict adverse outcome among (1) the entire p opulation, (2) complicated pregnancies, (3) uncomplicated pregnancies, (4) term, or (5) preterm gestation. RESULTS: The frequencies of abdom inal delivery for suspected fetal in tolerance and low Apgar scores we re similar among patients with IAFI less than or equal to 5.0 cm (n=28 8) versus those with IAFI >5.0 cm. All five receiver operating charact eristic curves indicated that IAFI is a poor predictor of adverse outc omes. At all the discriminatory IAFIs (0-20 cm), the false positive ra te was virtually identical to the true positive rate. CONCLUSION: IAFI appears to be a poor screening test for identifying those at risk for abdominal delivery for presumed fetal distress or for birth of an inf ant with low Apgar scores.