Abstract
Abstract
Objective
Amniotic fluid assessment is central to antepartum fetal surveillance. Current guidelines favor the maximum vertical pocket (MVP) over the amniotic fluid index (AFI), as AFI increases oligohydramnios diagnosis and labor induction rates without improving perinatal outcomes. Neither method accurately identifies true oligohydramnios by dye‐dilution techniques (sensitivity 6–30%), and the clinical significance of AFI‐detected oligohydramnios unconfirmed by MVP remains uncertain. We aimed to compare the diagnostic accuracy of AFI versus MVP for predicting adverse perinatal outcomes in singleton term pregnancies, with attention to discordant classifications.
Methods
Retrospective cohort study of 671 singleton pregnancies delivered at term (≥37 weeks) at a tertiary center (2017–2024). All patients underwent antepartum ultrasound within 7 days of delivery. Oligohydramnios was defined as AFI
Results
The composite outcome occurred in 124 pregnancies (18.5%). AFI identified oligohydramnios in 141 cases (21.0%) versus 55 for MVP (8.2%,
P
P
for interaction = 0.047).
Conclusion
AFI classified more pregnancies as oligohydramnios than MVP, but AFI‐only oligohydramnios was not associated with significantly worse outcomes in this MVP‐guided cohort. Both methods showed limited discriminatory performance, and these findings should not be interpreted as grounds to modify current guideline recommendations.