Could adverse perinatal outcome be predicted from intrapartum umbilical vessels Doppler in women with abnormal cardiotocography?

Abstract

Abstract Objectives To evaluate the value of umbilical artery and umbilical vein Doppler study in predicting adverse perinatal events in low risk women with abnormal cardiotocography during labor. Design Prospective cohort study. Setting Emergency unit of obstetrics & gynecology department, Royal Commission hospital, El Gubail Industrial City, Saudi Arabia. Population Sixty-six women with uncomplicated pregnancy were classified according to cardiotocography (CTG) findings during the active phase of labor into, 33 cases with normal CTG (group 1) and 33 cases with pathological CTG (group 2). Colour Doppler study of the umbilical artery (UA) and umbilical vein (UV) were performed for both groups and the results were correlated to perinatal outcome. Main outcome measures Meconium stained amniotic fluid, emergency Cesarean deliveries for suspected fetal distress. Apgar score at 1 and 5 min, UA and UV cord blood pH, and the need for neonatal intensive care unit (NICU) admission. Results In the pathological CTG group two (6.1%) cases had high UA Doppler indices with no adverse perinatal outcome, while 13 (39.4%) cases showed UV pulsations of them 12 (92.3%) cases underwent emergency cesarean section for fetal distress, 5 (38.4%) cases delivered babies with UV pH Normal UA Doppler indices and no UV pulsations were seen in all cases with normal CTG group with no adverse perinatal outcome. Conclusion UV Doppler study in combination with CTG monitoring as a part of the intra partum fetal surveillance in low risk pregnancy might give additional useful information about fetal condition and suspected intrapartum fetal hypoxia.