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Cited by 152Maternal and Perinatal Health InterventionsPreterm Birth and ChorioamnionitisPregnancy and preeclampsia studies

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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

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Kehl, S., Schelkle, A., Thomas, A., Puhl, A., Meqdad, K., Tuschy, B., Berlit, S., Weiss, C., Bayer, C., Heimrich, J., Dammer, U., Raabe, E., Winkler, M., Faschingbauer, F., Beckmann, M. W., Sütterlin, M.·2016·Ultrasound in Obstetrics & Gynecology
DOI 10.1002/uog.14924
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Abstract

Objective: To determine whether the amniotic fluid index (AFI) or the single deepest vertical pocket (SDP) technique for estimating amniotic fluid volume is superior for predicting adverse pregnancy outcome. Methods: This was a multicenter randomized controlled trial including 1052 pregnant women with a term singleton pregnancy across four hospitals in Germany. Women were assigned randomly, according to a computer‐generated allocation sequence, to AFI or SDP measurement for estimation of amniotic fluid volume. Oligohydramnios was defined as AFI ≤ 5 cm or the absence of a pocket measuring at least 2 × 1 cm. The diagnosis of oligohydramnios was followed by labor induction. The primary outcome measure was postpartum admission to a neonatal intensive care unit. Further outcome parameters were the rates of diagnosis of oligohydramnios and induction of labor (for oligohydramnios or without specific indication), and mode of delivery. Results: Postpartum admission to a neonatal intensive care unit was similar between groups (4.2% (n = 21) vs 5.0% (n = 25); relative risk (RR), 0.85 (95% CI, 0.48–1.50); P = 0.57). In the AFI group, there were more cases of oligohydramnios (9.8% (n = 49) vs 2.2% (n = 11); RR, 4.51 (95% CI, 2.2–8.57); P < 0.01) and more cases of labor induction for oligohydramnios (12.7% (n = 33) vs 3.6% (n = 10); RR, 3.50 (95% CI, 1.76–6.96); P < 0.01) than in the SDP group. Moreover, an abnormal cardiotocography was seen more often in the AFI group than in the SDP group (32.3% (n = 161) vs 26.2% (n = 132); RR, 1.23 (95% CI, 1.02–1.50); P = 0.03). The other outcome measures were not significantly different between the two groups. Conclusions: Use of the AFI method increased the rate of diagnosis of oligohydramnios and labor induction for oligohydramnios without improving perinatal outcome. The SDP method is therefore the favorable method to estimate amniotic fluid volume, especially in a population with many low‐risk pregnancies. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

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  1. Nabhan AF, 2008, Cochrane Database Syst Rev

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Authors
Kehl, S., Schelkle, A., Thomas, A., Puhl, A., Meqdad, K., Tuschy, B., Berlit, S., Weiss, C., Bayer, C., Heimrich, J., Dammer, U., Raabe, E., Winkler, M., Faschingbauer, F., Beckmann, M. W., & Sütterlin, M.
Affiliations
  • Heidelberg University (DE)
  • Charité – Universitätsmedizin Berlin (DE)
  • University Medical Center of the Johannes Gutenberg University Mainz (DE)
  • Universitätsklinikum Erlangen (DE)
Corresponding author
Kehl, S.
ORCID
Venue
Ultrasound in Obstetrics & Gynecology
Publisher
Wiley
Published
2016-06
Volume
47
Issue
6
Pages
674-679
ISSN
  • 0960-7692 (ISSN-L)
  • 1469-0705
DOI
10.1002/uog.14924
OpenAlex
W1921567863
Cited by
152
References
17
Citations by year
2026: 15 · 2025: 16 · 2024: 11 · 2023: 27 · 2022: 15 · 2021: 14 · 2020: 17 · 2019: 12 · 2018: 11 · 2017: 11 · 2016: 3
FWCI
9.46
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2 d)
Locations
  • Ultrasound in Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
  • Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords
amniotic fluid index, oligohydramnios, adverse pregnancy outcomes, neonatal intensive care admission, labor induction, cardiotocography, term singleton pregnancy, fetal monitoring, fetal growth restriction, macrosomia, fetal hypoxia, fetal distress, fetal malpresentation, fetal malposition
MeSH terms
Amniotic Fluid, Female, Humans, Labor, Induced, Patient Admission, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Intensive Care, Neonatal, Oligohydramnios, Ultrasonography, Prenatal

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