Does an amniotic fluid index of </=5 cm necessitate delivery in high-risk pregnancies? A case-control study.

Abstract

This study was undertaken to determine whether women with high-risk pregnancies and an amniotic fluid index of </=5 cm require labor induction to prevent adverse perinatal outcomes. All women at high risk at >/=34 weeks' gestation with an amniotic fluid index of </=5 cm were admitted to the hospital for labor induction. Each woman was compared with the next patient at high risk seen with an amniotic fluid index of >5 cm and the same pregnancy complication. Case patients were also matched with control subjects for maternal race, age, parity, and gestational age. Prospectively, 79 women at high risk with an amniotic fluid index of </=5 cm were compared with 79 control subjects. There were no statistically significant differences between the 2 groups in the risks of thick meconium (P =.29), variable decelerations (moderate P =.27, severe P =.37), amnioinfusion (P =.37), cesarean delivery for fetal distress (P =.4), and umbilical artery pH <7.10 (P =.29). High-risk pregnancies with an amniotic fluid index of </=5 cm appear to carry intrapartum complication rates similar to those of similar high-risk pregnancies with an amniotic fluid index of >5.