{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:08:58Z","timestamp":1789740538970,"version":"4.0.1"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Amniotic fluid assessment is central to antepartum fetal surveillance. Current guidelines favor the maximum vertical pocket (MVP) over the amniotic fluid index (AFI), as AFI increases oligohydramnios diagnosis and labor induction rates without improving perinatal outcomes. Neither method accurately identifies true oligohydramnios by dye\u2010dilution techniques (sensitivity 6\u201330%), and the clinical significance of AFI\u2010detected oligohydramnios unconfirmed by MVP remains uncertain. We aimed to compare the diagnostic accuracy of AFI versus MVP for predicting adverse perinatal outcomes in singleton term pregnancies, with attention to discordant classifications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective cohort study of 671 singleton pregnancies delivered at term (\u226537\u2009weeks) at a tertiary center (2017\u20132024). All patients underwent antepartum ultrasound within 7\u2009days of delivery. Oligohydramnios was defined as AFI &lt;5\u2009cm or MVP &lt;2\u2009cm. The primary composite outcome included cesarean delivery for nonreassuring fetal heart rate, 5\u2010min Apgar score &lt;7, umbilical artery pH &lt;7.10, or meconium\u2010stained fluid requiring neonatal airway intervention within 30\u2009min of birth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The composite outcome occurred in 124 pregnancies (18.5%). AFI identified oligohydramnios in 141 cases (21.0%) versus 55 for MVP (8.2%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). AFI showed higher sensitivity (26.6% vs. 10.5%) but lower specificity (80.3% vs. 92.3%). Positive predictive value and negative predictive value were similar between methods. Among 91 pregnancies with AFI\u2010only oligohydramnios, adverse outcome rates (22.0%) fell between concordant normal (17.3%) and concordant oligohydramnios (26.0%), although differences were nonsignificant. AFI oligohydramnios was not independently associated with adverse outcomes (adjusted odds ratio, 1.28 (95% confidence interval, 0.80\u20132.05). Sensitivity differences were most pronounced in small\u2010for\u2010gestational\u2010age pregnancies (AFI 45.1% vs. MVP 28.9%,\n                      <jats:italic>P<\/jats:italic>\n                      for interaction\u2009=\u20090.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AFI classified more pregnancies as oligohydramnios than MVP, but AFI\u2010only oligohydramnios was not associated with significantly worse outcomes in this MVP\u2010guided cohort. Both methods showed limited discriminatory performance, and these findings should not be interpreted as grounds to modify current guideline recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.71346","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T13:47:43Z","timestamp":1789739263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Amniotic fluid index versus maximum vertical pocket for predicting adverse perinatal outcomes in singleton term pregnancies: A retrospective cohort study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5537-7935","authenticated-orcid":false,"given":"Manal","family":"Massalha","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Canada"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion \u2013 Israel Institute of Technology  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gharid Nourallah","family":"Bekdache","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryon","family":"DeFrance","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinga","family":"Malinowski","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Canada"},{"name":"Department of Health Research, Evidence, and Impact McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon F.","family":"Barrett","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eran","family":"Ashwal","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McMaster University  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(89)90527-9"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000290349.58707.e0"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(84)90359-4"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(00)70345-0"},{"issue":"8","key":"e_1_2_14_6_1","first-page":"601","article-title":"Amniotic fluid index measurements during pregnancy","volume":"32","author":"Phelan JP","year":"1987","journal-title":"J Reprod Med"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(84)90360-0"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006593.pub2"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004410"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14924"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.04.016"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12589"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002042"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xagr.2022.100091"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)90009-v"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(99)70015-3"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181841395"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.181.1.1887021"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2023.05.022"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1927.10502953"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02295996"},{"issue":"3","key":"e_1_2_14_22_1","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach","volume":"44","author":"DeLong ER","year":"1988","journal-title":"Biometrics"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780429246593"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.107325"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015151516"}],"container-title":["International Journal of Gynecology &amp; 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