title: Placental and fetal hemodynamics in prolonged pregnancies.
abstract: OBJECTIVE
  We hypothesized that Doppler measurements of the placental and fetal central and peripheral hemodynamics would predict adverse outcomes in prolonged uncomplicated singleton pregnancies.
  
  
  METHODS
  A total of 160 participants were recruited to this study. Doppler measurements of placental and fetal hemodynamics as well as cardiotocography (CTG) were assessed prior to induction of labor at >41+ weeks. CTG during delivery, umbilical artery (UA) pH and base excess at birth and neonatal data were evaluated.
  
  
  RESULTS
  In 16% of cases the outcome was unfavorable, defined as UA pH <7.10, 5-min Apgar score <7, cesarean delivery for fetal distress and/or need for admission to neonatal intensive care. There were no differences in the pulsatility indices of the uterine and umbilical arteries, middle cerebral artery, descending aorta, ductus venosus and inferior vena cava between the groups with favorable and unfavorable outcome. In addition, the ventricular inflow patterns, outflow velocities of the great arteries, cardiac outputs and myocardial performance indices were similar between the groups.
  
  
  CONCLUSIONS
  Doppler parameters of the placental and fetal central and peripheral hemodynamics do not differ prior to the induction of labor in prolonged pregnancies with favorable and unfavorable outcomes. This suggests that their value is limited and that other clinical tools are needed for intermittent fetal surveillance in prolonged pregnancies. © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Obstetrics and Gynecology and PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Kauppinen
authors.affiliation: Department of Obstetrics and Gynecology and PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Kantomaa
authors.affiliation: Department of Obstetrics and Gynecology and PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland.|Department of Obstetrics and Gynecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
authors.forename: Aydin
authors.initials: A
authors.lastname: Tekay
authors.affiliation: Department of Obstetrics and Gynecology and PEDEGO Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland.|Department of Obstetrics and Gynecology, Turku University Hospital and University of Turku, Turku, Finland.
authors.forename: Kaarin
authors.initials: K
authors.lastname: Mäkikallio
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging*; D001034:Apgar Score; D015148:Cardiotocography; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology*; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D007751:Labor, Induced; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055988:Uterine Artery / Q000000981:diagnostic imaging*; D014620:Vacuum Extraction, Obstetrical / Q000706:statistics & numerical data; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging*; D055815:Young Adult