A1 Refereed original research article in a scientific journal
Placental and fetal hemodynamics in prolonged pregnancies
Authors: Kauppinen T, Kantomaa T, Tekay A, Makikallio K
Publisher: WILEY-BLACKWELL
Publication year: 2016
Journal: Prenatal Diagnosis
Journal name in source: PRENATAL DIAGNOSIS
Journal acronym: PRENATAL DIAG
Volume: 36
Issue: 7
First page : 622
Last page: 627
Number of pages: 6
ISSN: 0197-3851
DOI: https://doi.org/10.1002/pd.4828
Abstract
ObjectiveWe hypothesized that Doppler measurements of the placental and fetal central and peripheral hemodynamics would predict adverse outcomes in prolonged uncomplicated singleton pregnancies.MethodA total of 160 participants were recruited to this study. Doppler measurements of placental and fetal hemodynamics as well as cardiotocography (CTG) were assessed prior to induction of labor at >41+weeks. CTG during delivery, umbilical artery (UA) pH and base excess at birth and neonatal data were evaluated.ResultsIn 16% of cases the outcome was unfavorable, defined as UA pH <7.10, 5-min Apgar score <7, cesarean delivery for fetal distress and/or need for admission to neonatal intensive care. There were no differences in the pulsatility indices of the uterine and umbilical arteries, middle cerebral artery, descending aorta, ductus venosus and inferior vena cava between the groups with favorable and unfavorable outcome. In addition, the ventricular inflow patterns, outflow velocities of the great arteries, cardiac outputs and myocardial performance indices were similar between the groups.ConclusionDoppler parameters of the placental and fetal central and peripheral hemodynamics do not differ prior to the induction of labor in prolonged pregnancies with favorable and unfavorable outcomes. This suggests that their value is limited and that other clinical tools are needed for intermittent fetal surveillance in prolonged pregnancies. (c) 2016 John Wiley & Sons, Ltd.
ObjectiveWe hypothesized that Doppler measurements of the placental and fetal central and peripheral hemodynamics would predict adverse outcomes in prolonged uncomplicated singleton pregnancies.MethodA total of 160 participants were recruited to this study. Doppler measurements of placental and fetal hemodynamics as well as cardiotocography (CTG) were assessed prior to induction of labor at >41+weeks. CTG during delivery, umbilical artery (UA) pH and base excess at birth and neonatal data were evaluated.ResultsIn 16% of cases the outcome was unfavorable, defined as UA pH <7.10, 5-min Apgar score <7, cesarean delivery for fetal distress and/or need for admission to neonatal intensive care. There were no differences in the pulsatility indices of the uterine and umbilical arteries, middle cerebral artery, descending aorta, ductus venosus and inferior vena cava between the groups with favorable and unfavorable outcome. In addition, the ventricular inflow patterns, outflow velocities of the great arteries, cardiac outputs and myocardial performance indices were similar between the groups.ConclusionDoppler parameters of the placental and fetal central and peripheral hemodynamics do not differ prior to the induction of labor in prolonged pregnancies with favorable and unfavorable outcomes. This suggests that their value is limited and that other clinical tools are needed for intermittent fetal surveillance in prolonged pregnancies. (c) 2016 John Wiley & Sons, Ltd.
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