The prediction of intra-partum fetal compromise in prolonged pregnancy.
This is a prospective study conducted in a dedicated post-dates clinic to investigate the importance of antenatal ultrasound, Doppler and cardiotocographic (CTG) indices in the prediction of adverse intra-partum events in prolonged pregnancy. Operative delivery for abnormal fetal ECG-ST segment analysis and/or an arterial cord pH < 7.15 were regarded as adverse events. There were 462 singleton pregnancies with 87 adverse intra-partum events included in the analysis. Intra-partum adverse events were associated with nulliparity, oligohydramnios and induction of labour. The birth weight of fetuses was significantly less in the group with adverse intra-partum events. Logistic regression analysis showed that only nulliparity, birth weight and oligohydramnios had a significant independent influence on the risk of an adverse intra-partum event. Nulliparity was associated with five-fold increase in risk of an adverse intra-partum event. Oligohydramnios was associated with a three-fold increase in the risk. The risk decreased with increasing birth weight.
Singh
T
T
Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St Georges Hospital NHS Trust, London, UK.
Sankaran
S
S
Thilaganathan
B
B
Bhide
A
A
D000328:Adult; D015148:Cardiotocography; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D011273:Pregnancy, Prolonged; D011296:Prenatal Diagnosis