Randomised controlled trial of cardiotocography versus umbilical artery Doppler in the management of small for gestational age fetuses.
OBJECTIVE
To compare the impact on use of resources in the management of small for gestational age babies using Doppler ultrasound versus cardiotocography.


METHODS
A randomised controlled trial.


METHODS
A large district general hospital delivering 5500 to 6000 infants each year, 30% to 35% of which are to women of Pakistani origin.


METHODS
One hundred and fifty women delivered of small for gestational age infants.


METHODS
Primary outcome measures were length of hospital inpatient stay and induction of labour rates. Secondary outcome measures included caesarean section rates and length of stay on neonatal unit.


RESULTS
The use of Doppler reduced average hospital inpatient stay from 2.5 days to 1.1 days, compared with cardiotocography (P = 0.036). There was no effect on induction of labour rates or caesarean section rates. There was no significant difference in length of stay on the neonatal unit (P = 0.33). There was a reduction in monitoring frequency and fewer hospital antenatal clinic visits.


CONCLUSIONS
The use of Doppler ultrasound to manage small for gestational age infants reduces the use of resources, compared with cardiotocography.
Haley
J
J
Department of Obstetrics, Bradford Royal Infirmary, West Yorkshire, UK.
Tuffnell
D J
DJ
Johnson
N
N
D015148:Cardiotocography / Q000379:methods*; D002585:Cesarean Section; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D011247:Pregnancy; D011256:Pregnancy Outcome; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*