title: A pilot randomized controlled trial of two regimens of fetal surveillance for small-for-gestational-age fetuses with normal results of umbilical artery doppler velocimetry.
abstract: OBJECTIVE
  This study was undertaken to determine whether the frequency of fetal surveillance could be safely reduced from twice weekly to fortnightly in the case of small-for-gestational-age fetuses with normal results of umbilical artery Doppler velocimetry studies.
  
  
  METHODS
  Pregnant women between 24 and 36 weeks' gestation (n = 167) with small-for-gestational-age fetuses and normal results of umbilical artery Doppler velocimetry studies were randomly allocated to undergo twice-weekly or fortnightly fetal surveillance. Statistical analysis was carried out according to intention to treat.
  
  
  RESULTS
  Eighty-five women were randomly assigned to undergo twice-weekly fetal surveillance and 82 were randomly assigned to undergo fortnightly fetal surveillance. Those randomly assigned to twice-weekly surveillance were delivered 4 days earlier (264 vs 268 days; P =.04) and were more likely to have labor induced (n = 70, 82%, vs n = 54, 66%; P =.02) than those randomly assigned to fortnightly surveillance. Fifty-four babies (23%) were admitted to the neonatal nursery, but there were no differences in neonatal morbidity between the groups.
  
  
  CONCLUSIONS
  Maternal intervention (induction) was more common in the twice-weekly group. No differences in neonatal outcomes were detected. A much larger trial is required to determine the safety and potential benefits of less frequent surveillance of small-for gestational-age fetuses with normal results of umbilical artery Doppler velocimetry studies.
authors.affiliation: Department of Obstetrics and Gynaecology, Neonatal Paediatrics, and Community Health, University of Auckland, New Zealand.
authors.forename: L M
authors.initials: LM
authors.lastname: McCowan
authors.forename: J E
authors.initials: JE
authors.lastname: Harding
authors.forename: A B
authors.initials: AB
authors.lastname: Roberts
authors.forename: S E
authors.initials: SE
authors.lastname: Barker
authors.forename: C
authors.initials: C
authors.lastname: Ford
authors.forename: A W
authors.initials: AW
authors.lastname: Stewart
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D005323:Fetal Monitoring / Q000379:methods*; D020567:Fetal Weight; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007751:Labor, Induced; D017078:Laser-Doppler Flowmetry; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D014469:Umbilical Arteries / Q000503:physiopathology*