Category: Antepartum Fetal Assessment
Poster Session III
We sought to determine whether Doppler-flow measurements before performing induction of labor predict non reassuring fetal heart rate and cesarean section rate in pregnant women at 38-41 weeks of gestation.
Study Design:
A prospective observational study from a single medical center. Women with a singleton pregnancy at term at 38-41 weeks of gestations who were admitted for induction of labor were included. Each woman underwent baseline sonographic evaluation before induction of labor that included measuring the pulsatility index in the middle cerebral artery (MCA) and umbilical artery (UA) and the ratio between them (cerebroplacental ratio-CPR). The insertion of an intracervical Foley catheter balloon (FCB) or placement of intracervical or vaginal prostaglandins (PG-E2) were used for cervical ripening. Pregnancy outcome in those who developed non reassuring fetal heart rate (NRFHR) and those with reassuring FHR during labor were compared and correlated with baseline Doppler-flow indices and method of induction.
Results:
A group of 133 women underwent induction of labor with PG-E2 and 86 women underwent induction of labor with FCB. Rate of cesarean section (CS) were significantly higher among women with NRFHR compared with those who had reassuring FHR. The MCA PI and the CPR were significantly higher in women with reassuring FHR pattern compared with those with NRFHR in those induced by PG-E2.
Conclusion:
The MCA PI and the CPR indices measured before induction of labor, predict NRFHR during labor and may assist in using the appropriate method of induction.
Daniel Tairy, MD (he/him/his)
Resident
Wolfson Medical Center
Holon, HaMerkaz, Israel
Jacob Bar, MD
Division head
Wolfson Hospital
Holon, HaMerkaz, Israel, Israel
Lilia Tamayev, MD
Edith Wolfson Medical Center
Holon, Alabama, United States
Yossi Mizrachi, MD
The Edith Wolfson medical center
Holon, HaMerkaz, Israel, Israel
Giulia Barda, MD
Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center
Holon, HaMerkaz, Israel, Israel
Eldar Volpert, MD
Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center
Holon, HaMerkaz, Israel, Israel