Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics

Objective: To assess the added value of Doppler parameters, maternal history, and intrapartum clinical characteristics for the prediction of emergency delivery due to non-reassuring fetal status in low-risk pregnancies. Methods: This was a prospective cohort of low-risk pregnancies undergoing ultras...

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Autores: Crovetto F, Cesano N, Rossi F, Acerboni S, Marinis SDE, Basso A, Martinez Portilla RJ, Acaia B, Fedele L, Ferrazzi E, Persico N
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p16738
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16738
Access Level:acceso abierto
Palabra clave:Appropriate-gestational-age
cerebroplacental ratio
fetal Doppler
middle cerebral artery
small-gestational-age
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spelling Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristicsCrovetto FCesano NRossi FAcerboni SMarinis SDEBasso AMartinez Portilla RJAcaia BFedele LFerrazzi EPersico NAppropriate-gestational-agecerebroplacental ratiofetal Dopplermiddle cerebral arterysmall-gestational-ageObjective: To assess the added value of Doppler parameters, maternal history, and intrapartum clinical characteristics for the prediction of emergency delivery due to non-reassuring fetal status in low-risk pregnancies. Methods: This was a prospective cohort of low-risk pregnancies undergoing ultrasound assessment at 40?weeks? gestation within 7?days of delivery. The main outcome was emergency cesarean section due to non-reassuring fetal status. The association between Doppler parameters, intrapartum clinical characteristics, and maternal history was performed by logistic regression. The predictive performance of the constructed models was assessed by receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC). Results: From 403 included pregnancies, 18.6% (n?=?75) underwent an emergency delivery due to non-reassuring fetal status. The mean gestational age at birth was 40.5 (SD 5) days. Middle cerebral artery pulsatility index (MCA) and cerebroplacental ratio (CPR) were lower in the emergency cesarean section group (1.16 versus 1.30; p?<?.001, and 1.61 versus 1.78; p?=?.001, respectively). There was a higher incidence of small-for-gestational-age neonates (20 versus 10.1%; p?=?.017), lower Apgar scores at the 5th minute (9.7 versus 9.9; p?=?.006), and NICU admissions (9 versus 3%; p?=?.016) in the emergency cesarean section group. The base model comprised nulliparity, and the finding of meconium-stained amniotic fluid during labor, achieving an AUC of 66%, while the addition of the MCA Z-score significantly improved the previous model (AUC: 73%; DeLong: p?=?.008). Conclusions: In low-risk pregnant woman at term, the addition of MCA Z-score to a previous model comprising maternal history and intrapartum clinical findings, significantly improves the prediction of emergency delivery due to non-reassuring fetal status.TAYLOR & FRANCIS LTD2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16738Journal of Maternal-Fetal & Neonatal MedicineISSN: 14767058ISSNe: 14764954reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p167382026-05-27T12:37:41Z
dc.title.none.fl_str_mv Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
title Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
spellingShingle Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
Crovetto F
Appropriate-gestational-age
cerebroplacental ratio
fetal Doppler
middle cerebral artery
small-gestational-age
title_short Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
title_full Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
title_fullStr Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
title_full_unstemmed Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
title_sort Intrapartum prediction of emergency delivery due to non-reassuring fetal status at 40 weeks? gestation in low-risk pregnancies: contribution of Doppler parameters, maternal history, and intrapartum clinical characteristics
dc.creator.none.fl_str_mv Crovetto F
Cesano N
Rossi F
Acerboni S
Marinis SDE
Basso A
Martinez Portilla RJ
Acaia B
Fedele L
Ferrazzi E
Persico N
author Crovetto F
author_facet Crovetto F
Cesano N
Rossi F
Acerboni S
Marinis SDE
Basso A
Martinez Portilla RJ
Acaia B
Fedele L
Ferrazzi E
Persico N
author_role author
author2 Cesano N
Rossi F
Acerboni S
Marinis SDE
Basso A
Martinez Portilla RJ
Acaia B
Fedele L
Ferrazzi E
Persico N
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Appropriate-gestational-age
cerebroplacental ratio
fetal Doppler
middle cerebral artery
small-gestational-age
topic Appropriate-gestational-age
cerebroplacental ratio
fetal Doppler
middle cerebral artery
small-gestational-age
description Objective: To assess the added value of Doppler parameters, maternal history, and intrapartum clinical characteristics for the prediction of emergency delivery due to non-reassuring fetal status in low-risk pregnancies. Methods: This was a prospective cohort of low-risk pregnancies undergoing ultrasound assessment at 40?weeks? gestation within 7?days of delivery. The main outcome was emergency cesarean section due to non-reassuring fetal status. The association between Doppler parameters, intrapartum clinical characteristics, and maternal history was performed by logistic regression. The predictive performance of the constructed models was assessed by receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC). Results: From 403 included pregnancies, 18.6% (n?=?75) underwent an emergency delivery due to non-reassuring fetal status. The mean gestational age at birth was 40.5 (SD 5) days. Middle cerebral artery pulsatility index (MCA) and cerebroplacental ratio (CPR) were lower in the emergency cesarean section group (1.16 versus 1.30; p?<?.001, and 1.61 versus 1.78; p?=?.001, respectively). There was a higher incidence of small-for-gestational-age neonates (20 versus 10.1%; p?=?.017), lower Apgar scores at the 5th minute (9.7 versus 9.9; p?=?.006), and NICU admissions (9 versus 3%; p?=?.016) in the emergency cesarean section group. The base model comprised nulliparity, and the finding of meconium-stained amniotic fluid during labor, achieving an AUC of 66%, while the addition of the MCA Z-score significantly improved the previous model (AUC: 73%; DeLong: p?=?.008). Conclusions: In low-risk pregnant woman at term, the addition of MCA Z-score to a previous model comprising maternal history and intrapartum clinical findings, significantly improves the prediction of emergency delivery due to non-reassuring fetal status.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16738
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=16738
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv TAYLOR & FRANCIS LTD
publisher.none.fl_str_mv TAYLOR & FRANCIS LTD
dc.source.none.fl_str_mv Journal of Maternal-Fetal & Neonatal Medicine
ISSN: 14767058
ISSNe: 14764954
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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