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Archives of Gynecology and Obstetrics

, Volume 300, Issue 3, pp 575–581 | Cite as

Correlation of short-term variation and Doppler parameters with adverse perinatal outcome in small-for-gestational age fetuses at term

  • Florian M. StumpfeEmail author
  • Florian Faschingbauer
  • Sven Kehl
  • Jutta Pretscher
  • Patrick Stelzl
  • Andreas Mayr
  • Ralf L. Schild
  • Matthias Schmid
  • Matthias W. Beckmann
  • Michael O. Schneider
Maternal-Fetal Medicine
  • 26 Downloads

Abstract

Objective

To evaluate the association of short-term variation (STV) and Doppler parameters with adverse perinatal outcome in small-for-gestational-age (SGA) fetuses at term.

Methods

In this retrospective single-center study 97 patients with singleton SGA fetuses at term (≥ 37 + 0 weeks’ gestation) were examined. Inclusion criteria were a birth weight < 10th centile, cephalic presentation and planned vaginal birth. Only cases with available Doppler measurements of umbilical artery (UA) and middle cerebral artery (MCA) with calculated cerebroplacental ratio (CPR) in combination with a computerized CTG (cCTG) and STV 72 h prior to delivery were eligible for analysis. Pulsatility indices (PI) were converted into multiples of median (MoM), adjusted for gestational age.

The association between Doppler indices and STV values with mode of delivery [secondary cesarean delivery (CD), operative vaginal delivery (OVD), as well as secondary CD and OVD due to fetal distress] and neonatal outcome [UA blood pH ≤ 7.15 and the need of admission to the neonatal intensive care unit (NICU)] was analyzed using logistic regression analysis.

Results

There was a significant association between UA PI MoM and the rate of CD. CD due to fetal distress, OVD and OVD due to fetal distress did not show a correlation with the evaluated Doppler parameters. Furthermore, we did not find an association between low UA birth pH and Doppler parameters while neonates with the need of admission to NICU had significant higher UA PI MoM and significant lower MCA PI MoM and CPR MoM. Regarding STV, a significant effect of low STV on NICU admission was found while none of the other assessed outcome parameters were significantly associated with STV.

Conclusion

STV and Doppler parameters in SGA fetuses at term are significantly associated to the rate of NICU admission.

Keywords

Doppler Cerebroplacental ratio Fetal distress Short-term variation Computerized CTG Cardiotocography SGA small-for-gestational age 

Notes

Author contributions

FMS: project development, data collection, data interpretation, manuscript writing—original draft. FF: project development, date interpretation, supervision, manuscript writing: review and editing. SK: data interpretation, and critical revision of the manuscript. JP: data collection, and critical revision of the manuscript. PS: data collection, and critical revision of the manuscript. AM: data analysis, data interpretation, and critical revision of the manuscript. RLS: supervision, and critical revision of the manuscript. MS: data analysis, and critical revision of the manuscript. MWB: supervision, and critical revision of the manuscript. MOS: data collection, and manuscript writing—original draft.

Compliance with ethical standards

Conflict of interest

Author FMS declares that he has no conflict of interest. Author FF declares that he has no conflict of interest. Author SK declares that he has no conflict of interest. Author JP declares that she has no conflict of interest. Author PS declares that he has no conflict of interest. Author AM declares that he has no conflict of interest. Author RLS declares that he has no conflict of interest. Author MS declares that he has no conflict of interest. Author MWB declares that he has no conflict of interest. Author MOS declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Klinisches Ethikkomitee des Universitätsklinikums Erlangen) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Florian M. Stumpfe
    • 1
    Email author
  • Florian Faschingbauer
    • 1
  • Sven Kehl
    • 1
  • Jutta Pretscher
    • 1
  • Patrick Stelzl
    • 1
  • Andreas Mayr
    • 2
  • Ralf L. Schild
    • 3
  • Matthias Schmid
    • 2
  • Matthias W. Beckmann
    • 1
  • Michael O. Schneider
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity Hospital of ErlangenErlangenGermany
  2. 2.Department of Medical Informatics, Biometry and Epidemiology, Medical FacultyUniversity of BonnBonnGermany
  3. 3.Department of Obstetrics and Perinatal MedicinePerinatalzentrum HannoverHannoverGermany

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