Umbilical Artery Systolic/Diastolic Ratio and Amniotic Fluid Index in Prediction of Fetal Outcome in Term Pregnancies

Background: Amniotic fluid index (AFI) and umbilical artery (UA) Doppler velocimetry both form an essential part of the antenatal surveillance in the assessment of fetal well-being. The aim of this work was to assess sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of UA systolic/diastolic (S/D) ratio and AFI in prediction of fetal outcomes in term pregnancies.Methods: This prospective observational cohort study was carried out on 113 female patients aged from 18 to 40 years old, with term pregnancy (37w6d -40w) and singleton pregnancy. All patients were subjected to UA S/D ratio and AFI measurement. Results: APGAR score was significantly higher at 10 min than at 1 min and 5 min (P <0.001). S/D ratio and AFI can’t significantly predict appearance, pulse, grimace, activity, and respiration (APGAR) score at 10 min and respiratory distress syndrome (RDS) grade 1 respectively (P= 0.374, 0.497, 0.062, <0.001) at cut-off <3,>8,<3,<8 with 100%, 56.67%, 57.14%, 85.71% sensitivity, 9.43%,45.28%, 49.06%, 56.60% specificity, 55.6%, 54%, 6.9%, 11.5% PPV and 100%, 48%,94.5% and 98.4% NPV. Systolic\diastolic ratio and AFI can significantly predict meconium- stained aspiration respectively (P = 0.001, 0.050) at cut-off <3, <8 with 75.00%, 75.00% sensitivity, 72.48%, 55.96% specificity, 5.9% PPV and 98.7% and 98.4% NPV.Conclusions: AFI and umbilical artery S/D ratio can significantly predict APGAR score at 5 minutes. AFI can predict meconium-stained aspiration and RDS grade 1.