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Re: AFIFrom: Terry J. DuBose (DuBoseTerryJ@Exchange.UAMS.edu)Sat Sep 11 14:00:42 1999
Dr. Smeltzer, I am not sure I agree with your statement that: "The largest single pocket predates the AFI by decade(s), was never shown to be inferior to it...." The following reference was very convincing to me that the AFI is superior to the single largest pocket measurement. "Sepulveda, Flack, & Fisk, using an infusion method in severe oligohydramnios and anhydramnios pregnancies, found that the AFI (4-quadrant sum) was more accurate than the single pocket method." Their methods seem to be a unique and elegant approach to this question. Peace, Terry J. DuBose, M.S., RDMS Little Rock, Arkansas USA ------------------------
At Wed, 08 Sep 1999, James S Smeltzer MD wrote:
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> -- ------------------------ >Dear Joe, > >The largest single pocket predates the AFI by decade(s), was never shown to >be inferior to it, was shown to agree with expert subjective (?!) >assessment & with AFI. We grasp at pseudoquantitative measures to provide >a level of truth that lacks, IMHO. There are several older studies that >indicate that AF not relevant until truly oligo (<1cm). There is a recent >study indicating that Doppler is better predictor than AF in IUGR & that AF >measure better than the rest of the BPP for the same purpose. > >My recommendation is to provide referring physicians with information that >they can unambiguously use for patient management. For this one it would >be AFI - which does encourage a systematic search for fluid. I provide a >bottom line clinical impression in all abnormalities of fluid or other >measures of fetal status & their clinical significance in the setting of >the patient's problems & indications (& in normal ones in which measures >are relevant). This is the "interpretation", which constitutes the medical >practice part of sonology, IMHO. > >Jim S > >At 12:37 AM 9/4/1999 -0500, you wrote: >> Is amniotic fluid index an outdated technique? Referring some articles >>on medline- largest single pocket has replaced AFI- is that true? One >>referring doc insisted on AFI-- I have no literature describing the >>method. Do you take the total of all four quadrants in cms? or is the >>average of largest pockets taken-- ie: divided by 4? Please describe >>exactly how to estimate AFI. Regards, DR.JOE ANTONY
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