Objective: We studied whether Doppler flow measurements before initiation of induction of labor (IOL) can predict non-reassuring fetal heart rate (NRFHR) monitoring in women at 38-41 weeks of gestation.
Materials And Methods: We performed a prospective observational study in a single tertiary medical center between November 2017 and December 2019. Women undergoing induction of labor were included. Each woman underwent sonographic studies before initiating IOL. The pregnancy outcome in those who developed NRFHR and those with reassuring FHR during labor were compared and correlated with baseline Doppler flow indices and method of induction.
Results: Overall, 219 women were included, of whom 133 underwent IOL with prostaglandin E2 and 86 with a Foley catheter balloon. On multivariate logistic regression analysis, a lower MCA-PI percentile was associated with NRFHR in women that were induced with prostaglandin E2.
Conclusion: A lower middle cerebral artery pulsatility index value might represent a lower placental reserve and, therefore, a higher risk of NRFHR monitoring during labor. This finding might assist in selecting the appropriate method of IOL.
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Author Affiliations: College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado (Drs Smith, Thumm, Barton, and Hernandez); Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado (Dr Giano); Biostatistics Core, University of Colorado Cancer Center, Aurora, Colorado (Ms Staley); Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, School of Medicine, Colorado (Dr Sheeder); Division of Endocrinology, Metabolism, & Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado (Dr Hernandez); and Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado (Dr Hernandez).
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