title: Cardiovascular profile score as a predictor of acute intrapartum non-reassuring fetal status in infants with congenital heart defects.
abstract: OBJECTIVE
  To investigate the predictive factors of urgent cesarean delivery (CD) due to acute intrapartum non-reassuring fetal status (NRFS) in infants with congenital heart defects (CHDs).
  
  
  METHODS
  This was a retrospective review of 199 singletons prenatally diagnosed with a CHD and for whom vaginal delivery was attempted in our institution between 2007 and 2014. A cardiovascular profile (CVP) score was used to assess fetal heart failure.
  
  
  RESULTS
  The number of urgent CDs due to NRFS was 37 (18.6%). Fetuses with a CVP score ≤7 were significantly more likely to require urgent CD due to NRFS than those with a CVP score ≥8 (p < 0.001). Infants with right heart defects or biventricular cyanotic heart defects had a significantly higher frequency of urgent CD due to NRFS than those with other types of CHD (p = 0.017). Multivariate analysis showed that a CVP score ≤7, a birth weight <2500 g, and primipara status were significant predictors of urgent CD due to NRFS.
  
  
  CONCLUSIONS
  Fetal heart failure, low birth weight, and primipara status were revealed to be independent predictors of urgent CD due to acute intrapartum NRFS in CHD infants. The CVP score may be a useful echocardiographic marker in perinatal management planning.
authors.affiliation: a Departments of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Takekazu
authors.initials: T
authors.lastname: Miyoshi
authors.affiliation: a Departments of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Katsuragi
authors.affiliation: a Departments of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Neki
authors.affiliation: b Pediatric Cardiology, National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Ken-Ichi
authors.initials: KI
authors.lastname: Kurosaki
authors.affiliation: b Pediatric Cardiology, National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.affiliation: c Department of Statistics and Data Analysis , Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Michikazu
authors.initials: M
authors.lastname: Nakai
authors.affiliation: c Department of Statistics and Data Analysis , Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: a Departments of Perinatology and Gynecology , National Cerebral and Cardiovascular Center , Suita , Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Yoshimatsu
authors.affiliation: d Department of Obstetrics and Gynecology , Mie University , Tsu , Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000208:Acute Disease; D000328:Adult; D004452:Echocardiography; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005323:Fetal Monitoring / Q000379:methods*; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006340:Heart Rate, Fetal; D006801:Humans; D036801:Parturition / Q000502:physiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D012107:Research Design; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal
keywords: Cardiovascular profile score; congenital heart defect; echocardiography; fetal heart failure; non-reassuring fetal status; prenatal diagnosis