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. 2022 Apr-Jun;12(2):76-81.
doi: 10.4103/ijabmr.ijabmr_452_21. Epub 2022 May 10.

Umbilical Artery Systolic/Diastolic Ratio and Amniotic Fluid Index in Prediction of Adverse Perinatal Outcome in Term Pregnancies

Medhavi Sharma  1 , Gaurav Sharma  2 , Anjana Verma  3
Affiliations

Umbilical Artery Systolic/Diastolic Ratio and Amniotic Fluid Index in Prediction of Adverse Perinatal Outcome in Term Pregnancies

Medhavi Sharma et al. Int J Appl Basic Med Res. 2022 Apr-Jun.

Abstract

Background: Antenatal fetal surveillance is a field of increasing importance in modern obstetrics. It is based on fetal heart rate monitoring using nonstress test and contraction stress test, ultrasound biometry and amniotic fluid assessment, Doppler blood flow studies of fetal and uteroplacental circulation, and an evaluation of biophysical fetal parameters. The combination of these methods leads to improvements in fetal morbidity and mortality.

Aim: The present study aimed to assess the sensitivity, specificity, and positive and negative predictive values of umbilical artery (UA) systolic/diastolic (S/D) ratio, and amniotic fluid index (AFI) in term pregnancies for the prediction of perinatal outcome and their relation with perinatal outcome.

Methods: This study was conducted at a tertiary care hospital on 100 pregnant women where all the term singleton pregnancies (37-42 weeks) admitted in maternity were subjected to color Doppler for UA S/D ratio assessment and AFI estimation. Further, management of patients was done according to color Doppler findings and their relation with perinatal outcome.

Results: Out of 100 pregnant women, 68% had AFI >8 (normal), while 32% of women had AFI <8 (abnormal), with the mean AFI being 9.39 ± 2.55 cm, whereas70% had S/D ratio <3 (normal) and 30% of women had S/D ratio >3 (abnormal), with the mean S/D ratio of 2.61 ± 0.450. UA S/D ratio had better performance values (i.e., sensitivity, specificity, and positive and negative predictive value) than AFI in predicting adverse perinatal outcomes.

Conclusion: AFI and UA S/D ratio are important for predicting low appearance, pulse, grimace, activity, and respiration score, meconium, respiratory complications, and perinatal mortality in high as well as low-risk pregnancy cases. However, UA S/D ratio is a better predictor of perinatal outcome in high-risk pregnancies.

Keywords: Amniotic fluid index; activity; and respiration; appearance; color doppler; grimace; meconium; negative predictive value; perinatal outcome; positive predictive value; pulse; sensitivity; specificity; umbilical artery systolic/diastolic ratio.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Indications for cesarean section
Figure 2
Figure 2
Distribution of cesarean patients having oligohydramnios (amniotic fluid index < 8) along with other high-risk factors
See this image and copyright information in PMC

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References

    1. Goyal S, Suresh A, Rao AA. Amniotic fluid index versus umbilical artery Doppler velocimetry in prediction of perinatal outcome. Int J Innov Res Dev. 2014;3:91–4.
    1. O'Neill E, Thorp J. Antepartum evaluation of the fetus and fetal well being. Clin Obstet Gynecol. 2012;55:722–30. - PMC - PubMed
    1. Arduini D, Rizzo G, Romanini C. Changes of pulsatility index from fetal vessels preceding the onset of late decelerations in growth-retarded fetuses. Obstet Gynecol. 1992;79:605–10. - PubMed
    1. Sterne G, Shields LE, Dubinsky TJ. Abnormal fetal cerebral and umbilical Doppler measurements in fetuses with intrauterine growth restriction predicts the severity of perinatal morbidity. J Clin Ultrasound. 2001;29:146–51. - PubMed
    1. Arias F. Accuracy of the middle-cerebral-to-umbilical-artery resistance index ratio in the prediction of neonatal outcome in patients at high risk for fetal and neonatal complications. Am J Obstet Gynecol. 1994;171:1541–5. - PubMed