PubMed Health⌕ Search

Biomedical subjects

L Scheerer

Publications and source records attributed to L Scheerer.

3 recordsLinked to original sources

Cord-containing amniotic fluid pocket: a useful measurement in the management of oligohydramnios.

OBJECTIVE: To test the hypothesis that among patients with a low amniotic fluid (AF) index, those who have a large cord-containing AF pocket will have a lower risk for adverse perinatal outcome than women with a small cord-containing pocket. METHODS: Gravidas with an antepartum AF index no greater than 5 cm were studied prospectively. The vertical diameter of the single largest cord-containing pocket, which was excluded from the calculation of the AF index, was measured. Women with rupture of the membranes, multiple gestation, or fetal anomalies were excluded. RESULTS: Fifty-one women with gestational ages of 35-43 weeks were analyzed. Among 35 who had a cord-containing pocket of no more than 5 cm, eight (23%) had fetal distress necessitating operative delivery and eight neonates had cord arterial pH below 7.20. None of these complications occurred in the 16 women who had a cord-containing pocket above 5 cm (P < .05). The mean AF index (2.9 versus 2.8 cm) was not significantly different between the groups. CONCLUSION: Among women with a low AF index, a cord-containing pocket above 5 cm identifies a subgroup of women at lower perinatal risk compared with those with a smaller cord-containing pocket. The need for intervention may be reduced in women with a cord-containing pocket greater than 5 cm.

Adult↗

Maternal hydration increases amniotic fluid index.

Although adequate amniotic fluid (AF) volume is considered an important aspect of fetal well-being, the etiology of decreased AF volume is not well understood. A randomized blinded trial was designed to examine our hypothesis that maternal hydration would increase the AF index in women with low AF indexes. Women seen in our testing centers were randomized into control or hydration groups. The control group was instructed to drink their normal amount of fluid; the hydration group was instructed to drink 2 L of water, in addition to their usual amount of fluid, 2-4 hours before the post-treatment AF index. The women returned for the post-treatment AF index the same or following day. The mean post-treatment AF index was significantly greater in the hydration group (6.3 versus 5.1; P less than .01), as was the mean change in AF index (post-treatment AF index--pre-treatment AF index: 1.5 versus 0.31; P less than .01). These findings suggest that maternal oral hydration increases AF volume in women with decreased fluid levels.

Amniotic Fluid↗

Measurement of fetal shoulder width with computed tomography in diabetic women.

We conducted a feasibility study of the use of computed tomography (CT) to measure the width of the fetal shoulders and to predict large birth weight in infants of diabetic mothers. Computed tomography pelvimetry using low-dose digital radiographs was performed before delivery at term in 22 diabetic women. Shoulder width was estimated by direct electronic measurement on a single axial section through the shoulders of the fetus, and by orthopedic calipers within 48 hours of birth. Shoulder width by CT was 11.4-16.5 cm, and correlated significantly with postnatal measurements (r = 0.66, P = .01). Shoulder width by CT also correlated well with birth weight (r = 0.84, P less than .01), and measured more than 14 cm in all seven infants with birth weights more than 4200 g. Using 14 cm as a positive test and birth weight 4200 g as an abnormal result, the predictive value of a positive test was 78% and the predictive value of a negative test was 100%. This technique deserves further evaluation in assessing the risk of shoulder dystocia in potentially macrosomic infants.

Birth Weight↗