In:
Fetal Diagnosis and Therapy, S. Karger AG, Vol. 48, No. 8 ( 2021), p. 624-632
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 This study investigated whether fetal growth deceleration in term, appropriate-for-gestational-age (AGA) fetuses is associated with placental insufficiency and nonreassuring fetal heart rate (NRFHR) at birth. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 In this prospective study, 246 low-risk, singleton pregnancies at term with AGA fetuses were recruited. Correlation between decreased growth velocity (decline in estimated fetal weight [EFW] percentile), low EFW (EFW 〈 sup 〉 Q1 〈 /sup 〉 = latest EFW between 11 and 25% percentiles), umbilical artery (UA) pulsatility index (PI), middle cerebral artery (MCA) PI, and cerebro-placental ratio (CPR) with cesarean and instrumental deliveries due to NRFHR were tested. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The median change between fetal weight estimates (percentiles/week) was +0.49% (95% CI: −4 to +5%). Ten percent had decreased EFW percentile & #x3e;3.5%/week. Fetal growth velocity/week was associated with MCA ( 〈 i 〉 r 〈 /i 〉 = 0.21, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) and CPR ( 〈 i 〉 r 〈 /i 〉 = 0.24, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) and inversely correlated with UA PI ( 〈 i 〉 r 〈 /i 〉 = −0.28, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). NRFHR and cesarean section (CS) rates due to NRFHR were associated with decreased growth velocity, EFW 〈 sup 〉 Q1 〈 /sup 〉 , and low CPR. The combination of abnormal CPR with decreased growth velocity occurred in 12 pregnancies, of which 5 (42%) had urgent CS due to NRFHR. The combination of abnormal CPR with EFW 〈 sup 〉 Q1 〈 /sup 〉 occurred in 9 pregnancies, of which 4 (44%) had urgent CS due to NRFHR. These combinations increased the likelihood ratio of CS due to NRFHR two-fold (8.41; 2.54–24.5) but did not significantly alter the number needed to treat by elective CS (3.78–4.68). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Fetal growth velocity, EFW between 10 and 25th percentiles (EFW 〈 sup 〉 Q1 〈 /sup 〉 ), and abnormal CPR improves prediction of unplanned CS due to NRFHR among term AGA fetuses. This should be considered when counseling about the delivery method.
Type of Medium:
Online Resource
ISSN:
1015-3837
,
1421-9964
Language:
English
Publisher:
S. Karger AG
Publication Date:
2021
detail.hit.zdb_id:
1482292-1
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