Choosing Wisely:

Don’t use amniotic fluid index to make a diagnosis of oligohydramnios (in the third trimester).

Rationale and Comments: Amniotic fluid volume can be measured using either the amniotic fluid index or the deepest vertical pocket. Diagnosis of oligohydramnios based on an amniotic fluid index of <5 cm has been found to lead to a greater number of obstetric interventions without a significant benefit in improving perinatal outcomes when compared to use of a deepest vertical pocket of <2 cm for diagnosis.
Sponsoring Organizations:
  • Society for Maternal-Fetal Medicine
  • Sources:
  • Randomized controlled trials
  • Disciplines:
  • Obstetrical
  • References: • Kehl S, Schelkle A, Thomas A, Puhl A, Meqdad K, Tuschy B, et al. Single deepest vertical pocket or amniotic fluid index as evaluation test for predicting adverse pregnancy outcome (SAFE trial): a multicenter, open-label, randomized controlled trial. Ultrasound Obstet Gynecol. 2016;47(6):674-9.
    • Ultrasound in pregnancy. Practice Bulletin No. 175. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2016;128:e241-56.
    • Antepartum fetal surveillance. Practice Bulletin No. 145. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2014;124:182-92.

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