Key result
Fetal ductus venosus monitoring fails to improve 2-year neurodevelopment-free survival over CTG.
Why the study?
In pregnancies complicated by fetal growth restriction between 26 and 32 weeks, the optimal monitoring strategy to determine timing of delivery and improve infant survival without neurological impairment remains uncertain.
Does monitoring of fetal ductus venosus (DV) waveform improve 2-year survival without neurological impairment compared to CTG-STV monitoring in pregnancies complicated by fetal growth restriction delivering before 32 weeks?
RCT (n=317)
Randomly allocated
Does monitoring of fetal ductus venosus (DV) waveform improve 2-year survival without neurological impairment compared to CTG-STV monitoring in pregnancies complicated by fetal growth restriction delivering before 32 weeks?
Absolute Event Rate: 83% vs 77%
p-value: p=0.21
In pregnancies with fetal growth restriction delivering before 32 weeks, timing delivery based on ductus venosus waveform changes did not significantly improve overall survival without neurological impairment compared to CTG, but improved neurological outcomes among survivors.
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Raises caution on DV monitoring for early FGR delivery timing; leaves open optimal strategy pending higher-level evidence.
Ganzevoort et al. (2017) conducted an RCT in Fetal growth restriction (FGR) (n=317). Fetal ductus venosus (DV) waveform monitoring vs. Computed cardiotocography (CTG) short-term variation (STV) monitoring was evaluated on 2-year survival without neurological impairment (p=0.21). Fetal ductus venosus waveform monitoring compared to CTG short-term variation did not significantly improve 2-year survival without neurological impairment (83% vs 77%; P=0.21).