Objective: To assess the added value of Doppler parameters, maternal history, and intrapartum clinical characteristics for the prediction of emergency delivery due to non-reassuring fetal status in low-risk pregnancies.
Methods: This was a prospective cohort of low-risk pregnancies undergoing ultrasound assessment at 40 weeks' gestation within 7 days of delivery. The main outcome was emergency cesarean section due to non-reassuring fetal status. The association between Doppler parameters, intrapartum clinical characteristics, and maternal history was performed by logistic regression. The predictive performance of the constructed models was assessed by receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC).
Results: From 403 included pregnancies, 18.6% ( = 75) underwent an emergency delivery due to non-reassuring fetal status. The mean gestational age at birth was 40.5 (SD 5) days. Middle cerebral artery pulsatility index (MCA) and cerebroplacental ratio (CPR) were lower in the emergency cesarean section group (1.16 versus 1.30; < .001, and 1.61 versus 1.78; = .001, respectively). There was a higher incidence of small-for-gestational-age neonates (20 versus 10.1%; = .017), lower Apgar scores at the 5th minute (9.7 versus 9.9; = .006), and NICU admissions (9 versus 3%; = .016) in the emergency cesarean section group. The base model comprised nulliparity, and the finding of meconium-stained amniotic fluid during labor, achieving an AUC of 66%, while the addition of the MCA Z-score significantly improved the previous model (AUC: 73%; DeLong: = .008).
Conclusions: In low-risk pregnant woman at term, the addition of MCA Z-score to a previous model comprising maternal history and intrapartum clinical findings, significantly improves the prediction of emergency delivery due to non-reassuring fetal status.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/14767058.2019.1671338 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cranial, Renal, and Skeletal Anomalies in a Fetus With a Pathogenic Variant in the TAFAZZIN Gene.
Prenat Diagn
January 2025
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Objective: To report a case of a fetus with multiple congenital anomalies and suspected Barth syndrome, highlighting potential phenotypic expansion of the syndrome.
Methods: A 32-year-old G4P2011 patient was referred at 18w5d gestation for suspected fetal encephalocele. Serial imaging, including ultrasound and MRI, was performed to evaluate fetal anomalies.
Determinant of adverse early neonatal outcomes following emergency cesarean section in North West, Ethiopia: institutional-based case-control study.
BMC Pregnancy Childbirth
December 2024
College of Health Science, Department of Midwifery, Arsi University, Asella, Ethiopia.
Background: The World Health Organization recommends a cesarean delivery rate of 5-15%, which is thought to be within the range that can reduce infant morbidity and mortality. Various investigations have shown that those poor newborn outcomes are influenced by a variety of maternal and fetal factors and are more prevalent in emergencies than planned cesarean deliveries. Ethiopia is one of the five nations that account for 50% of all neonatal fatalities worldwide.
View Article and Find Full Text PDFSafety of vaginal breech delivery following an unsuccessful external cephalic version: a comparative study.
Arch Gynecol Obstet
December 2024
Tel Aviv University School of Medicine, Tel Aviv, Israel.
Objective: To determine whether patients undergoing a trial of labor with a breech presentation following a failed attempt of external cephalic version (ECV) are at increased risk of adverse maternal and neonatal outcomes.
Methods: This retrospective cohort study was conducted at a single university-affiliated medical center. The study group comprised women with singleton pregnancies at term, categorized into three groups: those who underwent a failed external cephalic version (ECV) and subsequently attempted a trial of breech delivery (Breech-failed-ECV group), those who attempted an assisted vaginal breech delivery without a prior ECV attempt (Breech-no-ECV group), and those with vertex presentation following a successful ECV (Vertex-ECV).
Autologous Blood Donation and Transfusion in Patients with Placental Malposition: A Single-Institution Pilot Study and Systematic Literature Review.
Healthcare (Basel)
October 2024
Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, 377-2 Ohnohigashi, Osakasayama 589-8511, Osaka, Japan.
Article Synopsis
- A study at Kindai University Hospital evaluated the usefulness of autologous blood donation for patients with placental malposition over ten years, focusing on its effectiveness in avoiding allogeneic blood transfusions.
- Of the 52 patients reviewed, only 9.6% successfully avoided using donated blood from another person, while complications occurred in 15% of donations, although no lasting effects were noted.
- A systematic review found no scientific evidence supporting the benefit of autologous blood transfusion for this condition, leading to the conclusion that such donations offer minimal advantage.
Incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Uganda: a prospective cohort study.
BMC Pregnancy Childbirth
October 2024
Kampala International University Western Campus, Bushenyi, Uganda.
Background: High rates of adverse neonatal outcomes in resource-limited settings are multifactorial, varying by country, region, and institution. In sub-Saharan Africa, the majority of adverse neonatal outcomes are intrapartum related, and studies in Uganda have shown that referral in labor is a major determinant of adverse neonatal outcomes. This study aimed to assess the incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Eastern Uganda.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!