Does gestational age at term play a role in the association between cerebroplacental ratio and operative delivery for intrapartum fetal compromise?
Adult
Blood Flow Velocity
Cesarean Section
Cohort Studies
Female
Fetal Distress
/ diagnostic imaging
Gestational Age
Humans
Infant, Newborn
Middle Cerebral Artery
/ diagnostic imaging
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Pulsatile Flow
Retrospective Studies
Time Factors
Ultrasonography, Prenatal
Umbilical Arteries
/ diagnostic imaging
appropriate for gestational age
cerebroplacental ratio
intrapartum fetal compromise
operative delivery
small for gestational age
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
27
05
2021
received:
06
03
2021
accepted:
29
06
2021
pubmed:
3
7
2021
medline:
28
9
2021
entrez:
2
7
2021
Statut:
ppublish
Résumé
To assess the impact of gestational age at term on the association between cerebroplacental ratio (CPR) and operative delivery for intrapartum fetal compromise (IFC) and prognostic performance of CPR to predict operative delivery for IFC. This was a retrospective cohort study including 2052 singleton pregnancies delivered between 37 Of the study cohort, 308 (15%) had a CPR <10th centile, 374 (18%) operative delivery for IFC, and 298 (15%) were SGA at birth. Overall, the rates of operative delivery for IFC were higher in the low CPR group both in SGA (35% vs. 22%; p = 0.023) and in AGA (23% vs. 16%; p = 0.007). According to gestational age by week at delivery, fetuses with low CPR showed higher rates of operative delivery for IFC with advancing gestational age, mainly in pregnancies delivered at 40 weeks (54% vs. 23%; p = 0.004) and at 41 weeks (60% vs. 19%; p = 0.010) for SGA and at 41 weeks (39% vs. 20%; p = 0.001) for AGA. The predictive value of CPR remained stable throughout term and was poor both in SGA and in AGA. Both SGA and AGA fetuses with low CPR showed higher rates of operative delivery for IFC at term with advancing gestational age. Prognostic value of CPR throughout term was poor.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1910-1916Informations de copyright
© 2021 Nordic Federation of Societies of Obstetrics and Gynecology.
Références
DeVore GR. The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses. Am J Obstet Gynecol. 2015;213:5-15.
Vollgraff Heidweiller-Schreurs CA, De Boer MA, Heymans MW, et al. Prognosis accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;51:313-322.
Morales-Roselló J, Khalil A, Morlando M, Bhide A, Papageorghiou A, Thilaganathan B. Poor neonatal acid-base status in term fetuses with low cerebroplacental ratio. Ultrasound Obstet Gynecol. 2015;45:156-161.
Akolekar R, Ciobanu A, Zingler E, Syngelaki A, Nicolaides KH. Routine assessment of cerebroplacental ratio at 35-37 weeks’ gestation in the prediction of adverse perinatal outcome. Am J Obstet Gynecol. 2019;221(65):e1-18.
Clark SL, Hankins GD. Temporal and demographic trends in cerebral palsy-fact and fiction. Am J Obstet Gynecol. 2003;188:628-633.
Bligh LN, Alsolai AA, Greer RM, Kumar S. Cerebroplacental ratio thresholds measured within 2 weeks before birth and risk of cesarean section for intrapartum fetal compromise and adverse neonatal outcome. Ultrasound Obstet Gynecol. 2018;52:340-346.
Ayres-de-Campos D, Spong CY, Chandraharan E. FIGO Intrapartum Fetal Monitoring Expert Consensus Panel. FIGO consensus guidelines on intrapartum fetal monitoring: cardiotocography. Int J Gynaecol Obstet. 2015;131:13-24.
Baschat AA, Gembruch U. The cerebroplacental Doppler ratio revisited. Ultrasound Obstet Gynecol. 2003;21:124-127.
Palacio M, Figueras F, Zamora L, et al. Reference ranges for umbilical and middle cerebral artery pulsatility index and cerebroplacental ratio in prolonged pregnancies. Ultrasound Obstet Gynecol. 2004;24:647-653.
Voigt M, Rochow N, Schneider KT, et al. New percentile values for the antropometric dimensions of singleton neonates: analysis of perinatal survey data of 2007-2011 from all 16 states of Germany. Z Geburtshilfe Neonatol. 2014;218:210-217.
Paules C, Youssef L, Rovira C, et al. Distinctive patterns of placental lesions in preeclampsia versus fetal growth restriction and their association with fetoplacental Doppler. Ultrasound Obstet Gynecol. 2019;54:609-616.
Thompson RS, Trudinger BJ. Doppler waveform pulsatility index and resistance, pressure and flow in the umbilical placental circulation: an investigation using a mathematical model. Ultrasound Med Biol. 1990;16:449-458.
Cruz-Martínez R, Figueras F, Hernandez-Andrade E, Oros D, Gratacos E. Fetal brain Doppler to predict cesarean delivery for nonreassuring fetal status in term small-for-gestational-age fetuses. Obstet Gynecol. 2011;117:618-626.
Prior T, Mullins E, Bennett P, Kumar S. Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study. Am J Obstet Gynecol. 2013;208(124):e1-6.
Khalil AA, Morales-Rosello J, Morlando M, et al. Is fetal cerebroplacental ratio an independent predictor of intrapartum fetal compromise and neonatal unit admission? Am J Obstet Gynecol. 2015;213(54):e1-10.
Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014;36:86-98.
Salomon LJ, Alfirevic Z, Da Silva Costa F, et al. ISUOG practice guidelines: ultrasound assessment of fetal biometry and growth. Ultrasound Obtet Gynecol. 2019;53:715-723.
Kovo M, Schreiber L, Ben-Haroush A, et al. The placental factor in early- and late-onset normotensive fetal growth restriction. Placenta. 2013;34:320-324.
Figueras F, Caradeux J, Crispi F, Eixarch E, Peguero A, Gratacos E. Diagnosis and surveillance of late-onset fetal growth restriction. Am J Obstet Gynecol. 2018;218:S790-S802.e1.
Sultana Z, Maiti K, Aitken J, Morris J, Dedman L, Smith R. Oxidative stress, placental ageing-related pathologies and adverse pregnancy outcomes. Am J Reprod Immunol 2017;77. https://doi.org/10.1111/aji.12653
Heazell AE, Lacey HA, Jones CJ, Huppertz B, Baker PN, Crocker IP. Effects of oxygen on cell turnover and expression of regulators of apoptosis in human placental trophoblast. Placenta. 2008;29:175-186.
Levy R, Smith SD, Chandler K, Sadovsky Y, Nelson DM. Apoptosis in human cultured trophoblasts is enhanced by hypoxia and diminished by epidermal growth factor. Am J Physiol Cell Physiol. 2000;278:C982-988.
Roberts DJ. Placental pathology, a survival guide. Arch Pathol Lab Med. 2008;132:641-651.
Conde-Agudelo A, Villar J, Kennedy SH, Papageorghiou AT. Predictive accuracy of cerebroplacental ratio for adverse perinatal and neurodevelopmental outcomes in suspected fetal growth restriction: a systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2018;52:430-441.
Akolekar R, Syngelaki A, Gallo DM, Poon LC, Nicolaides KH. Umbilical and fetal middle cerebral artery Doppler at 35-37 weeks’ gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol. 2015;46:82-92.
Lobmaier SM, Figueras F, Mercade I, et al. Angiogenic factors vs Doppler surveillance in the prediction of adverse outcome among late-pregnancy small-for-gestational-age fetuses. Ultrasound Obstet Gynecol. 2014;43:533-540.
Kalafat E, Morales-Rosello J, Tilaganathan B, Tahera F, Khalil A. Risk of operative delivery for intrapartum fetal compromise in small-for-gestational-age foetuses at term: an internally validated prediction model. Am J Obstet Gynecol. 2018;218(134):e1-e8.