A randomized clinical trial of the intrapartum assessment of amniotic fluid volume: amniotic fluid index versus the single deepest pocket technique

Am J Obstet Gynecol. 2004 Jun;190(6):1564-9; discussion 1569-70. doi: 10.1016/j.ajog.2004.03.046.


Objective: The purpose of this study was to determine whether an intrapartum assessment of amniotic fluid identifies a pregnancy that is at risk for an adverse outcome.

Study design: Parturients who were admitted for delivery were assigned randomly to have the amniotic fluid assessed either by amniotic fluid index or by the presence of a 2 x 1 pocket.

Results: The amniotic fluid index was obtained in 499 pregnancies, and the 2 x 1 technique was performed in 501. Oligohydramnios was diagnosed in 25% of amniotic fluid index pregnancies versus 8% with the use of the 2 x 1 pocket technique (P <.001). Both techniques failed to identify patients who underwent an amnioinfusion for fetal distress (P=.864) or who experienced variable (P=.208) or late decelerations (P=.210) that influenced delivery, fetal distress in labor (P=.220), caesarean delivery for fetal distress (P=.133), and admission to neonatal intensive care unit (P=.686).

Conclusion: Neither the amniotic fluid index nor the 2 x 1 pocket technique that was undertaken as a fetal admission test identifies a pregnancy that is at risk for an adverse outcome.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amniocentesis
  • Amniotic Fluid / diagnostic imaging*
  • Cesarean Section*
  • Female
  • Fetal Distress / diagnosis*
  • Fetal Monitoring / methods
  • Humans
  • Obstetric Labor Complications / prevention & control*
  • Obstetrics / methods
  • Oligohydramnios / diagnostic imaging*
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome
  • Probability
  • Reference Values
  • Risk Assessment
  • Sensitivity and Specificity
  • Ultrasonography, Prenatal