Key result
Pre-labor maternal-fetal Doppler indices, FHR STV, and Dawes-Redman criteria were not predictive of composite neonatal morbidity or arterial cord blood pH < 7.2 in women at term.
Why the study?
The study sought to evaluate whether pre-labor maternal-fetal Dopplers and computerized fetal heart rate short-term variability relate to arterial cord blood pH and can predict composite neonatal morbidity at term in an unselected cohort.
Do pre-labor maternal-fetal Dopplers, FHR STV, and Dawes-Redman criteria predict composite neonatal morbidity and arterial cord blood pH in women with term singleton pregnancy?
Observational (n=218)
Do pre-labor maternal-fetal Dopplers, FHR STV, and Dawes-Redman criteria predict composite neonatal morbidity and arterial cord blood pH in women with term singleton pregnancy?
Pre-labor maternal-fetal Doppler indices, FHR STV, and Dawes-Redman criteria do not predict composite neonatal morbidity or low arterial cord blood pH in unselected women at term.
These indices should not guide intrapartum decisions in unselected term pregnancies; leaves open their value in higher-risk cohorts.
OBJECTIVES: To investigate (i) the association between pre-labor maternal-fetal Dopplers and fetal heart rate short-term variability (FHR STV) with arterial cord blood pH and (ii) the potential value of pre-labor maternal-fetal Dopplers, FHR STV and Dawes-Redman criteria in predicting composite neonatal morbidity at term in a cohort of unselected women. METHOD: A prospective study in 218 women with term singleton pregnancy in latent phase of labor or due to undergo induction of labor. Data on maternal characteristics, maternal-fetal Dopplers indices and computerized cardiotocography (CTG) findings of FHR STV and Dawes-Redman criteria were collected. Pearson correlation analysis was used to determine the relationship between maternal-fetal Dopplers and FHR STV and arterial cord blood pH. Logistic regression analysis was used to determine which factors amongst maternal characteristics, labor onset, indication of labor induction, estimated fetal weight (EFW), maternal-fetal Dopplers, FHR STV and Dawes-Redman criteria were significant predictors of composite neonatal morbidity and arterial cord blood pH less than 7.2. RESULT: Of the 218 cases, 12 (5.5%) women were delivered by emergency operative delivery for pathological CTG, and 42 babies (19.3%) had composite neonatal morbidities. Arterial cord blood pH was not associated with maternal-fetal Doppler indices and FHR STV, but rather it was associated with maternal age and body mass index. The composite neonatal morbidity and arterial cord blood pH less than 7.2 were not significantly associated with maternal characteristics, labor onset, indication of labor induction, pre-labor assessment of EFW, maternal-fetal Doppler indices, FHR STV and Dawes-Redman criteria by computerized CTG. CONCLUSION: In unselected women in latent phase of labor or undergoing induction of labor at term, admission maternal-fetal Doppler indices, FHR STV and Dawes-Redman criteria are not predictive of composite neonatal morbidity.
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Lam et al. (2020) conducted an observational in Term singleton pregnancy (n=218). Pre-labor maternal-fetal Doppler indices, FHR STV, and Dawes-Redman criteria was evaluated on Composite neonatal morbidity and arterial cord blood pH < 7.2. Pre-labor maternal-fetal Doppler indices, FHR STV, and Dawes-Redman criteria were not predictive of composite neonatal morbidity or arterial cord blood pH < 7.2 in women at term.
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