CAN AMNIOTIC-FLUID DISTRIBUTION PREDICT FETAL-OUTCOME

Objective: This study was designed to determine whether the distributi on pattern of amniotic fluid (AF) within the uterine cavity is related to perinatal outcome. Study design: One-hundred women in labor with i ntact membranes underwent a real time ultrasound examination to measur e the AF index. Patients were divided into two groups based on liquor distribution. Those with > 50% liquor distributed in upper quadrants f ormed the 'upper greater' group whereas the rest of the patients const ituted the 'lower greater' group. Pregnancy outcome was assessed with respect to incidence of fetal heart rate (FHR) abnormalities, operativ e delivery, meconium stained liquor, Apgar score < 7 at 1 and 5 min an d neonatal intensive care unit admissions. Results: A total of 100 pat ients were evaluated. The 'upper greater' group had a higher incidence of cesarean for non-reassuring FHR (40.74% vs. 9.6%, P < 0.001), pers istent variable deceleration (14.8% vs. 0%, P < 0.001) and bradycardia (25.9% vs. 4.1%, P < 0.001). There was no statistically significant d ifference in the Apgar score < 7 at 1 min and neonatal intensive care unit admissions in the two groups. Conclusions: Distribution of less l iquor in the lower quadrants of the uterus predisposed to abnormalitie s in FHR and hence, cesarean section. The distribution pattern did not have a predictive value for the perinatal outcome. (C) 1998 Internati onal Federation of Gynecology and Obstetrics.