Amniotic fluid index as a predictor of adverse perinatal outcome in the HELLP syndrome
Barrilleaux, P.Scott.; Magann, E.F.; Chauhan, S.P.; York, B.M.; Philibert, L.; Lewis, D.F.
Journal of Reproductive Medicine 52(4): 293-298
2007
ISSN/ISBN: 0024-7758 PMID: 17506369 Document Number: 612829
OBJECTIVE: To evaluate the prognostic value of an amniotic fluid index (AFT) ! 5 cm for an adverse perinatal outcome in pregnancies with the syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP syndrome).STUDY DESIGN: A prospective, observational study of patients with the HELLP syndrome. An ultrasound estimate of amniotic fluid volume was obtained on admission. Adverse intrapartum outcomes included amnioinfusion for variable decelerations and/or indicated abdominal/vaginal operative delivery for nonreassuring fetal heart rate changes. Maternal characteristics and perinatal outcome parameters were compared AFI <= vs. > 5 cm. Statistical analysis was performed using chi(2) analysis, Student's t test and receiver-operator characteristic curve (ROC) analysis.RESULTS: Between January 1996 and February 1999, 120 patients were enrolled. Twenty-six (22%) had an AFI <= 5 cm. This group did not differ from that with AFI > 5 cm regarding the severity of the HELLP syndrome, admission-to-delivery interval (p=0.354), variable decelerations in labor (p = 0.06), Apgar score of < 7 at minutes (p = 0.361), cesarean delivery for nonreassuring fetal status (p = 1.0) or significant fetal acidosis (pH < 7.0 [p = 0.210]). ROC analysis revealed no AFI measurement between 0 and 16 cm that was useful for identifying the compromised fetus.CONCLUSION: Antepartum/intrapartum performance of AFI in patients with the HELLP syndrome is a poor prognostic test for subsequent fetal compromise.