title: Screening for fetal distress in labour using the umbilical artery blood velocity waveform.
abstract: OBJECTIVE
  To investigate the potential value of umbilical artery blood velocity wave-form measurement as a screening test for intrapartum fetal distress on admission to the labour ward.
  
  
  METHODS
  Prospective study drawn from the local population of pregnant women.
  
  
  METHODS
  The labour ward of the Princess Anne Hospital, Southampton, UK.
  
  
  METHODS
  334 women with singleton pregnancies of at least 37 weeks gestation.
  
  
  METHODS
  Emergency caesarean section for fetal distress.
  
  
  RESULTS
  There was a twelve-fold increase in the rate of emergency caesarean section for fetal distress (95% Confidence Interval (CI), 4.9-29) among women with a systolic/diastolic (S/D) ratio > or = 3.0, when compared to those with an S/D ratio of < 3.0 (P < 0.00001). Measurement of the umbilical artery blood velocity waveform compared favourably with admission cardiotocography.
  
  
  CONCLUSIONS
  Umbilical artery blood velocity waveform analysis may be used to screen for fetal distress in labour and appears to be particularly sensitive to problems of placental origin. However, it is not likely to confer benefit in labour wards whose fetal heart rate monitoring policy is determined by pregnancy risk factors and admission cardiotocography.
authors.affiliation: Princess Anne Hospital, Southampton, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Somerset
authors.forename: A J
authors.initials: AJ
authors.lastname: Murrills
authors.forename: T
authors.initials: T
authors.lastname: Wheeler
mesh_terms: D001783:Blood Flow Velocity / Q000502:physiology; D002585:Cesarean Section; D005260:Female; D005316:Fetal Distress / Q000503:physiopathology* / Q000517:prevention & control; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D014469:Umbilical Arteries / Q000502:physiology*