Key result
A cardiovascular profile score ≤7 was significantly associated with a higher likelihood of urgent cesarean delivery due to non-reassuring fetal status compared to a score ≥8 (p < 0.001).
Why the study?
Does a low cardiovascular profile (CVP) score predict urgent cesarean delivery due to acute intrapartum non-reassuring fetal status in infants with congenital heart defects?
Observational (n=199)
No
Does a low cardiovascular profile (CVP) score predict urgent cesarean delivery due to acute intrapartum non-reassuring fetal status in infants with congenital heart defects?
p-value: p=<0.001
A cardiovascular profile score ≤7, low birth weight, and primipara status are independent predictors of urgent cesarean delivery due to acute intrapartum non-reassuring fetal status in infants with congenital heart defects.
CVP ≤7 may flag higher urgent CD risk in CHD pregnancies; leaves open prospective validation before guiding delivery planning.
OBJECTIVES: To investigate the predictive factors of urgent cesarean delivery (CD) due to acute intrapartum non-reassuring fetal status (NRFS) in infants with congenital heart defects (CHDs). STUDY DESIGN: This was a retrospective review of 199 singletons prenatally diagnosed with a CHD and for whom vaginal delivery was attempted in our institution between 2007 and 2014. A cardiovascular profile (CVP) score was used to assess fetal heart failure. RESULTS: The number of urgent CDs due to NRFS was 37 (18.6%). Fetuses with a CVP score ≤7 were significantly more likely to require urgent CD due to NRFS than those with a CVP score ≥8 (p < 0.001). Infants with right heart defects or biventricular cyanotic heart defects had a significantly higher frequency of urgent CD due to NRFS than those with other types of CHD (p = 0.017). Multivariate analysis showed that a CVP score ≤7, a birth weight <2500 g, and primipara status were significant predictors of urgent CD due to NRFS. CONCLUSIONS: Fetal heart failure, low birth weight, and primipara status were revealed to be independent predictors of urgent CD due to acute intrapartum NRFS in CHD infants. The CVP score may be a useful echocardiographic marker in perinatal management planning.
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Miyoshi et al. (2016) conducted an observational in Congenital heart defects (n=199). Cardiovascular profile (CVP) score ≤7 vs. CVP score ≥8 was evaluated on Urgent cesarean delivery due to acute intrapartum non-reassuring fetal status (p=<0.001). A cardiovascular profile score ≤7 was significantly associated with a higher likelihood of urgent cesarean delivery due to non-reassuring fetal status compared to a score ≥8 (p < 0.001).