{'fraction_non_alphanumeric': 0.043478260869565216, 'fraction_numerical': 0.02670807453416149, 'mean_word_length': 4.774193548387097, 'pattern_counts': {'":': 0, '<': 5, '<?xml version=': 0, '>': 2, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Amniotic fluid index as a predictor of adverse perinatal outcome in the HELLP syndrome.

OBJECTIVE
To evaluate the prognostic value of an amniotic fluid index (AFI) < or = 5 cm for an adverse perinatal outcome in pregnancies with the syndrome of hemolysis, elevated liver enzymes and low platelets (HELLP syndrome).


STUDY DESIGN
A prospective, observational study of patients with the HELLP syndrome. An ultrasound estimate of amniotic fluid volume was obtained on admission. Adverse intrapartum outcomes included amnioinfusion for variable decelerations and/or indicated abdominal/vaginal operative delivery for nonreassuring fetal heart rate changes. Maternal characteristics and perinatal outcome parameters were compared AFI < or = vs. > 5 cm. Statistical analysis was performed using chi2 analysis, Student's t test and receiver-operator characteristic curve (ROC) analysis.


RESULTS
Between January 1996 and February 1999, 120 patients were enrolled. Twenty-six (22%) had an AFI < or = 5 cm. This group did not differ from that with AFI > 5 cm regarding the severity of the HELLP syndrome, admission-to-delivery interval (p = 0.354), variable decelerations in labor (p = 0.06), Apgar score of < 7 at 5 minutes (p = 0.361), cesarean delivery for nonreassuring fetal status (p = 1.0) or significant fetal acidosis (pH < 7.0 [p = 0.2101). ROC analysis revealed no AFI measurement between 0 and 16 cm that was useful for identifying the compromised fetus.


CONCLUSION
Antepartum/intrapartum performance of AFI in patients with the HELLP syndrome is a poor prognostic test for subsequent fetal compromise.