Johnson Julie M, Chauhan Suneet P, Ennen Christopher S, Niederhauser Amy, Magann Everett F
Palmetto Health-Richland, Columbia, SC, USA.
Am J Obstet Gynecol. 2007 Aug;197(2):207.e1-7; discussion 207.e7-8. doi: 10.1016/j.ajog.2007.04.048.
The objective of the study was to ascertain the diagnostic accuracy of 3 criteria of oligohydramnios in identifying 4 peripartum complications.
The 3 definitions of oligohydramnios were amniotic fluid index (AFI) 5.0 cm or less and AFI <5% for gestational age (GA) using nomograms by Moore and Cayle or Magann et al. Likelihood ratio (LR) and guidelines by the Evidence-Based Medicine Working Group were used in the secondary analysis of previously published reports. AFI obtained during antepartum and intrapartum periods were analyzed separately.
The 95% confidence intervals for the prevalence of oligohydramnios using the 3 criteria are significantly different in the antepartum or intrapartum analysis. The LR was <6 for ante- and intrapartum AFI to identify cesarean delivery for nonreassuring fetal heart rate tracing, Apgar score 3 or less at 5 minutes, umbilical arterial pH <7.00, and newborns' weight 5% or less for GA.
The 3 criteria for determining the adequacy of amniotic fluid are not fungible, and they are not useful diagnostic tests for identifying peripartum complications because LR is <10.
本研究的目的是确定羊水过少的3项标准在识别4种围产期并发症方面的诊断准确性。
羊水过少的3种定义为羊水指数（AFI）≤5.0 cm，以及使用Moore和Cayle或Magann等人的列线图得出的AFI<胎龄（GA）的5%。在对先前发表报告的二次分析中使用了似然比（LR）和循证医学工作组的指南。分别分析产前和产时获得的AFI。
在产前或产时分析中，使用这3项标准得出的羊水过少患病率的95%置信区间存在显著差异。产前和产时AFI用于识别因胎儿心率监护异常而行剖宫产、5分钟时Apgar评分≤3、脐动脉pH<7.00以及出生体重<GA的5%的似然比<6。
用于确定羊水是否充足的3项标准不可互换，并且由于似然比<10，它们不是识别围产期并发症的有用诊断测试。
