title: Doppler velocimetry and adverse outcome in labor induction for late IUGR.
abstract: BACKGROUND
  Late onset intrauterine growth restriction (IUGR) represents one of the main causes of perinatal morbidity/mortality. No guidelines are available on labor induction in IUGRs, even if delivery at 37/38 weeks is suggested. This study aims to assess maternal-fetal variables related to adverse outcome in labor induction for late IUGR.
  
  
  METHODS
  One hundred cases of induction for late IUGR were retrospectively revised on fetal weight, MCA, UA, CPR and uterine artery (utA) Doppler, oligohydramnios, Bishop score, start of induction, augmentation. The variables were matched with the following adverse outcomes: CS or vacuum extractor delivery (IVD); NICU admission; low Apgar score; UA pH < 7.10.
  
  
  RESULTS
  Regular vaginal delivery occurred in 65% of cases; the rate of CS and IVD was 32% and 5%. UA, MCA and CPR abnormalities were all significantly related to a higher risk of CS. Bishop score < 3 and start of induction by oxitocin resulted statistically associated to CS, while prostaglandins were related to vaginal delivery. No augmentation and oxitocin in labor were positively related to vaginal delivery. Maternal morbidity and Bishop score < 3 showed a significant association with NICU admission.
  
  
  CONCLUSIONS
  Doppler velocimetry of UA, MCA and CPR are useful tools for the identification and management of the late term IUGRs.
authors.affiliation: a High Risk Pregnancy Unit, Careggi University Hospital,- Florence , Italy and.
authors.forename: Serena
authors.initials: S
authors.lastname: Simeone
authors.affiliation: b Fetal Medicine Unit, Careggi University Hospital,- Florence , Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Marchi
authors.affiliation: a High Risk Pregnancy Unit, Careggi University Hospital,- Florence , Italy and.
authors.forename: Rita
authors.initials: R
authors.lastname: Canarutto
authors.affiliation: a High Risk Pregnancy Unit, Careggi University Hospital,- Florence , Italy and.
authors.forename: Marianna
authors.initials: M
authors.lastname: Pina Rambaldi
authors.affiliation: a High Risk Pregnancy Unit, Careggi University Hospital,- Florence , Italy and.
authors.forename: Caterina
authors.initials: C
authors.lastname: Serena
authors.affiliation: a High Risk Pregnancy Unit, Careggi University Hospital,- Florence , Italy and.
authors.forename: Cristina
authors.initials: C
authors.lastname: Servienti
authors.affiliation: a High Risk Pregnancy Unit, Careggi University Hospital,- Florence , Italy and.
authors.forename: Federico
authors.initials: F
authors.lastname: Mecacci
mesh_terms: D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000009:adverse effects*; D017078:Laser-Doppler Flowmetry; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Doppler; labor induction; late IUGR