International Journal of Infertility & Fetal Medicine

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VOLUME 5 , ISSUE 1 ( January-April, 2014 ) > List of Articles

RESEARCH ARTICLE

Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study

Sailaja Devi Kallur, Nuzhat Aziz

Citation Information : Kallur SD, Aziz N. Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study. Int J Infertil Fetal Med 2014; 5 (1):22-26.

DOI: 10.5005/jp-journals-10016-1076

License: CC BY-NC 4.0

Published Online: 01-08-2016

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Aim

To determine the ability of fetal monitoring tests to predict adverse perinatal outcomes in absent end diastolic flow (AEDF) babies.

Materials and methods

A retrospective cohort study of pregnant women with AEDF during the period 2001 to 2009. Fetal monitoring tests of interest included amniotic fluid index (AFI), nonstress tests (NST), and Doppler flow studies. Adverse perinatal outcomes included perinatal/neonatal mortality, necrotizing enterocolitis, respiratory distress syndrome, and grades III/IV intraventricular hemorrhage. Sensitivity, specificity, likelihood ratios, adjusted odds ratios, area under the receiver operator characteristic curves (AUROC) and the 95% confidence intervals were determined.

Study included 142 women with AEDF who delivered before 34 weeks. Indications for delivery included abnormal AFI in 6 (4.23%), worsening Doppler in 31 (21.83%), and abnormal NST in 48 (33.80%). An adverse fetal event was noted in 107 [75.35%, 95% confidence interial (CI) 68.18%, 82.53%]. Birth weight adjusted odds for an adverse perinatal outcome decreased (Odds ratio: 0.79, 95% CI: 0.56, 1.10, p = 0.16) with an increase in each week of gestation. Fetal monitoring tests did not have clinically meaningful positive/negative likelihood ratio or significant AUROC.

Conclusion

Current fetal monitoring tests are more useful to identify noncompromised fetuses than to identify fetal distress. Delaying delivery till 34 weeks might improve outcomes.

How to cite this article

Kallur SD, Aziz N. Do Fetal Monitoring Tests predict Adverse Perinatal Outcomes in Pregnant Women with Absent End Diastolic Flow? A Retrospective Study. Int J Infertil Fetal Med 2014;5(1):22-26.


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  1. Intrauterine growth restriction. Obstet Gynecol 2002;99(3):490-496.
  2. Outcomes of severely abnormal umbilical artery Doppler velocimetry in structurally normal singleton fetuses. Obstet Gynecol 1996;87(3): 434-438.
  3. Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery. Lancet 1994;344(8938):1664-1668.
  4. Pathology and clinical implications of abnormal umbilical artery Doppler waveforms. Ultrasound Obstet Gynecol 1997;9(4):271-286.
  5. Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol 2007 Feb;109(2 Pt 1):253-261.
  6. What antepartum fetal test should guide the timing of delivery of the preterm growth-restricted fetus? A decision analysis. Am J Obstet Gynecol 2004;191(4):1477-1482.
  7. Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med 1999;340(16):1234-1238.
  8. Relationship between abnormal fetal testing and adverse perinatal outcomes in intrauterine growth restriction. Am J Obstet Gynecol 2007;196(5):e-48-e51.
  9. Umbilical artery Doppler indices in small for gestational age fetuses: correlation with adverse outcomes and placental abnormalities. J Ultrasound Med 2009 Dec;28(12):1603-1610.
  10. Ultrasound predictors of neonatal outcome in intrauterine growth restriction. Am J Perinatol 1996 Nov;13(8):465-471.
  11. Prognostic role of umbilical artery Doppler velocimetry in growth restricted fetuses. J Matern Fetal Neonatal Med 2002 Mar;11(3):199-203.
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