Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study

Prior, Tomas, Mullins, Edward, Bennett, Phillip and Kumar, Sailesh (2013) Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study. American Journal of Obstetrics and Gynecology, 208 2: 124.e1-124.e6. doi:10.1016/j.ajog.2012.11.016


Author Prior, Tomas
Mullins, Edward
Bennett, Phillip
Kumar, Sailesh
Title Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study
Journal name American Journal of Obstetrics and Gynecology   Check publisher's open access policy
ISSN 0002-9378
1097-6868
Publication date 2013-02-01
Year available 2012
Sub-type Article (original research)
DOI 10.1016/j.ajog.2012.11.016
Open Access Status Not Open Access
Volume 208
Issue 2
Start page 124.e1
End page 124.e6
Total pages 6
Place of publication Philadelphia, PA United States
Publisher Mosby
Language eng
Formatted abstract
Objective

To investigate the use of the fetal cerebroumbilical ratio to predict intrapartum compromise in appropriately grown fetuses.

Study Design

A prospective observational study set at Queen Charlotte's and Chelsea hospital, London, UK. Fetal biometry and Doppler resistance indices were measured in 400 women immediately before established labor. Labor was then managed according to local protocols and guidelines, and intrapartum and neonatal outcome details recorded.

Results

Infants delivered by cesarean section for fetal compromise had significantly lower cerebroumbilical ratios than those born by spontaneous vaginal delivery (1.52 vs 1.82, P ≤ .001). Infants with a cerebroumbilical ratio <10th percentile were 6 times more likely to be delivered by cesarean section for fetal compromise than those with a cerebroumbilical ratio ≥10th percentile (odds ratio, 6.1; 95% confidence interval, 3.03−12.75). A cerebroumbilical ratio >90th percentile appears protective of cesarean section for fetal compromise (negative predictive value 100%).

Conclusion

The fetal cerebroumbilical ratio can identify fetuses at high and low risk of a subsequent diagnosis of intrapartum compromise, and may be used to risk stratify pregnancies before labor.
Keyword Cerebroumbilical ratio
Doppler
Fetal compromise
Fetal distress
Labor
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID 1110691
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Sat, 06 Jun 2015, 02:48:08 EST by Mr Mathew Carter on behalf of School of Medicine