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Prospect for vaginal delivery of growth restricted fetuses with abnormal umbilical artery blood flow.

Li, Hui; Gudmundsson, Saemundur LU and Olofsson, Per LU (2003) In Acta Obstetricia et Gynecologica Scandinavica 82(9). p.828-833
Abstract
Background. The best mode of delivery in cases of intrauterine growth restriction (IUGR) with umbilical artery blood flow changes is not well elucidated.



Objective. To evaluate outcome in IUGR with umbilical artery blood flow changes planned for vaginal delivery after a negative oxytocin challenge test (OCT).



Methods. In 84 term singleton pregnancies with suspected IUGR and no unanimous indication for abdominal delivery, Doppler velocimetry and OCT were performed. Positive OCT cases were delivered by cesarean section, negative OCT cases planned for vaginal delivery.



Results. Umbilical artery Doppler velocimetry was normal in 51 cases (normal group) and abnormal in 33 cases (increased... (More)
Background. The best mode of delivery in cases of intrauterine growth restriction (IUGR) with umbilical artery blood flow changes is not well elucidated.



Objective. To evaluate outcome in IUGR with umbilical artery blood flow changes planned for vaginal delivery after a negative oxytocin challenge test (OCT).



Methods. In 84 term singleton pregnancies with suspected IUGR and no unanimous indication for abdominal delivery, Doppler velocimetry and OCT were performed. Positive OCT cases were delivered by cesarean section, negative OCT cases planned for vaginal delivery.



Results. Umbilical artery Doppler velocimetry was normal in 51 cases (normal group) and abnormal in 33 cases (increased pulsatility index with maintained forward diastolic flow). Gestational age at delivery was shorter (p = 0.008), positive OCT more common (33% vs. 16%; p = 0.06), and vaginal delivery less common (40% vs. 63%; p = 0.04) in the abnormal blood flow group compared with the normal flow group. When in labor, 68% in the abnormal flow group and 76% in the normal flow group delivered vaginally (p = 0.6). One baby had a lethal malformation and another suffered meconium aspiration and pneumothorax, but was discharged home healthy.



Conclusions. The vaginal delivery rate was significantly lower in the abnormal flow group compared with the normal flow group, but in cases finally destined for a trial of labor the vaginal delivery rates were similar. There was no indication that any fetus was exposed to detrimental hypoxia or distress. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Obstetricia et Gynecologica Scandinavica
volume
82
issue
9
pages
828 - 833
publisher
Wiley-Blackwell
external identifiers
  • wos:000184719900009
  • pmid:12911444
  • scopus:0042333440
ISSN
1600-0412
DOI
10.1034/j.1600-0412.2003.00213.x
language
English
LU publication?
yes
id
240d5ff7-1d76-4e59-aa02-10152717c64f (old id 117422)
date added to LUP
2007-07-25 13:27:48
date last changed
2018-10-03 11:08:32
@article{240d5ff7-1d76-4e59-aa02-10152717c64f,
  abstract     = {Background. The best mode of delivery in cases of intrauterine growth restriction (IUGR) with umbilical artery blood flow changes is not well elucidated.<br/><br>
<br/><br>
Objective. To evaluate outcome in IUGR with umbilical artery blood flow changes planned for vaginal delivery after a negative oxytocin challenge test (OCT).<br/><br>
<br/><br>
Methods. In 84 term singleton pregnancies with suspected IUGR and no unanimous indication for abdominal delivery, Doppler velocimetry and OCT were performed. Positive OCT cases were delivered by cesarean section, negative OCT cases planned for vaginal delivery.<br/><br>
<br/><br>
Results. Umbilical artery Doppler velocimetry was normal in 51 cases (normal group) and abnormal in 33 cases (increased pulsatility index with maintained forward diastolic flow). Gestational age at delivery was shorter (p = 0.008), positive OCT more common (33% vs. 16%; p = 0.06), and vaginal delivery less common (40% vs. 63%; p = 0.04) in the abnormal blood flow group compared with the normal flow group. When in labor, 68% in the abnormal flow group and 76% in the normal flow group delivered vaginally (p = 0.6). One baby had a lethal malformation and another suffered meconium aspiration and pneumothorax, but was discharged home healthy.<br/><br>
<br/><br>
Conclusions. The vaginal delivery rate was significantly lower in the abnormal flow group compared with the normal flow group, but in cases finally destined for a trial of labor the vaginal delivery rates were similar. There was no indication that any fetus was exposed to detrimental hypoxia or distress.},
  author       = {Li, Hui and Gudmundsson, Saemundur and Olofsson, Per},
  issn         = {1600-0412},
  language     = {eng},
  number       = {9},
  pages        = {828--833},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Prospect for vaginal delivery of growth restricted fetuses with abnormal umbilical artery blood flow.},
  url          = {http://dx.doi.org/10.1034/j.1600-0412.2003.00213.x},
  volume       = {82},
  year         = {2003},
}