Prediction of intrapartum Cesarean delivery for non-reassuring fetal status after a successful external cephalic version by a low pre-version pulsatility index of the fetal middle cerebral artery

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
T Y LeungT K Lau

Abstract

To determine whether a pre-version Doppler assessment of fetal cerebral and umbilical blood flow can predict the ultimate need for intrapartum Cesarean delivery after a successful external cephalic version (ECV). A prospective observational study on women undergoing ECV between 36 and 38 gestational weeks was performed over a 5-year period. The pulsatility index (PI) of the fetal middle cerebral artery (MCA) and umbilical artery, heart rate and amniotic fluid index were measured before ECV. Women who had successful ECV were then divided into three groups according to the mode of delivery: (1) vaginal delivery, (2) intrapartum Cesarean delivery for poor progress and (3) intrapartum Cesarean delivery for non-reassuring fetal status. The fetal blood flow parameters were compared between the groups. Potential predictors were further analyzed using receiver-operating characteristics curves. Of 174 women with successful ECV, 140 (80.5%) had vaginal delivery, 19 (10.9%) required emergency intrapartum Cesarean delivery for non-reassuring fetal status and 15 (8.6%) for poor progress. MCA-PI was significantly lower in the group with non-reassuring fetal status. MCA-PI is predictive of intrapartum Cesarean delivery (area under the curve =...Continue Reading

References

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Citations

Jan 23, 2016·Journal of Perinatology : Official Journal of the California Perinatal Association·A BasuS Kumar
Apr 29, 2015·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Tomas Prior, Sailesh Kumar
May 6, 2008·American Journal of Obstetrics and Gynecology·Marjolein KokBen Willem Mol
Nov 4, 2008·Obstetrics and Gynecology·Kim GrootscholtenJoris A van der Post
Jul 11, 2014·Journal of Personality Assessment·José Antonio López-PinaJosefa Ferrer-Requena
Jul 22, 2017·Journal of Biomolecular Structure & Dynamics·Petar M Mitrasinovic
Mar 17, 2010·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Chun Wai CheungTze Kin Lau
Apr 14, 2021·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·A YoussefA El-Balat
Feb 28, 2017·Gynécologie, Obstétrique, Fertilité & Sénologie·J BoujenahL Carbillon
Sep 28, 2017·Journal of Gynecology Obstetrics and Human Reproduction·J BoujenahL Carbillon

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