Abstract
Purpose: Intrapartum Doppler velocimetry is a non-invasive investigation method. This method is useful for evaluating the pathophysiological mechanisms underlying changes in fetal heart rate. This study aimed to determine the usefulness of Doppler ultrasound findings during labor in high-risk women on determining the mode of delivery and outcome of the newborn. Methods: A cross-sectional study was conducted from January 1, 2015 to December 31, 2015 on 100 high-risk pregnant women during labor. The study was performed in the Maternity Teaching Hospital in Erbil City, Kurdistan Region, Iraq. Results: The majority of women (77%) had a normal end-diastolic blood flow pattern through the umbilical artery. A total of 76.9% of those with abnormal Doppler results had a Cesarean delivery compared with only 9.5% of those with normal Doppler results (p < 0.001). The rate of early neonatal death was significantly higher (15.4%) in women with abnormal Doppler results than in those with normal Doppler results (1.4%, p = 0. 016). Admission to the neonatal intensive care unit was significantly more frequent in women with abnormal Doppler results than in those with normal Doppler results (61.5% vs. 17.6, p < 0.001). The same pattern was seen in the Apgar score in the first (p = 0.07) and fifth minutes (p = 0.01). Conclusions: Abnormal umbilical artery Doppler ultrasound findings in high-risk pregnancies for women in labor are associated with increased rates of emergency cesarean sections and a poor outcome of the newborn.
Highlights
This study aimed to determine the usefulness of Doppler ultrasound findings during labor in high-risk women on determining the mode of delivery and outcome of the newborn
Abnormal umbilical artery Doppler ultrasound findings in highrisk pregnancies for women in labor are associated with increased rates of emergency cesarean sections and a poor outcome of the newborn
Hamid et al 140 tum fetal monitoring. This reduces the burden of perinatal mortality and long-term morbidities, while avoiding unnecessary obstetric interventions [1]
Summary
Hamid et al 140 tum fetal monitoring. This reduces the burden of perinatal mortality and long-term morbidities, while avoiding unnecessary obstetric interventions [1]. The current evidence on fetal health surveillance during the antenatal and intrapartum period has shown that improvement in fetal outcome as a result of these modulations is difficult to document. This is because of variations in the interpretation of fetal monitoring tests, especially electronic fetal heart monitoring. There is limited evidence of randomized, clinical trials that support daily practice modalities that can be used for assessment of fetal wellbeing during the antenatal and intrapartum periods. The only testing modality for which there is Level 1 evidence is the use of umbilical artery Doppler for fetal surveillance in growth restricted fetuses [3]
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