Addition of Color Doppler Sonography for Detection of Amniotic Fluid Disturbances and Its Implications on Perinatal Outcomes

作者：Odibo Imelda N; Whittemore Brianna S; Hughes Dawn S; Simmons Pamela M; Ounpraseuth Songthip T; Magann Everett F^*

来源：Journal of Ultrasound in Medicine, 2017, 36(9): 1875-1881.

DOI：10.1002/jum.14223

• amniotic fluid index
• color Doppler sonography
• grayscale sonography
• obstetric ultrasound
• pregnancy outcome
• single deepest pocket

ObjectivesTo determine whether color Doppler sonography increases the detection of pregnancies at risk for adverse outcomes.
MethodsParticipants admitted to labor and delivery with the anticipation of a vaginal delivery underwent measurements of amniotic fluid volume (AFV) using amniotic fluid index (AFI) and single deepest pocket (SDP) techniques by grayscale followed by color Doppler sonography. Oligohydramnios was defined as an AFI of less than 5cm or an SDP of less than 2cm. Intrapartum and perinatal outcomes were compared between participants with a diagnosis of a low AFV by grayscale and color Doppler sonography.
ResultsOver 42 months, 428 women were enrolled in the study. Color Doppler sonography resulted in lower AFV estimates (meanSD by the AFI, 10.7 +/- 3.7cm by grayscale sonography and 8.6 +/- 3.6cm by color Doppler sonography; P< .0001). For the SDP, the mean AFVs were 4.6 +/- 2.0cm by grayscale sonography and 3.4 +/- 1.4cm by color Doppler sonography (P<.0001). The level of agreement between grayscale and color Doppler sonography in estimating the AFV was fair, with =0.32 for the AFI and 0.28 for the SDP. Outcome measures of AFVs classified as low based on color Doppler sonography (normal by grayscale sonography) and those classified as low by grayscale sonography (low by color Doppler sonography) were compared. There was no difference in composite perinatal complications, mode of delivery, or composite neonatal complications.
ConclusionsThe use of color Doppler sonography leads to the overdiagnosis of low AFVs and does not appear to increase the detection of pregnancies destined for adverse intrapartum or perinatal outcomes.

• 出版日期2017-9