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

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 Retrospective single-center study on 97 patients with SGA fetuses (≥ 37 + 0 weeks’ gestation).

Inclusion criteria were: birth weight < 10th centile, cephalic presentation, planned vaginal birth. Only cases with Doppler measurements of umbilical artery (UA) and middle cerebral artery (MCA) with cerebroplacental ratio (CPR) and available computerized CTG (cCTG) with STV 72 h prior to delivery were eligible for analysis. Pulsatility indices (PI) were converted into multiples of median (MoM).

Association between Doppler indices and STV values with mode of delivery [secondary cesarean delivery (CD), operative vaginal delivery (OVD), secondary CD and OVD due to fetal distress] and neonatal outcome [UA pH ≤ 7.15 and admission to the neonatal intensive care unit (NICU)] was analyzed.

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 Doppler parameters. Furthermore, there was no association between low UA birth pH and Doppler parameters. Neonates admitted to NICU had significant higher UA PI MoM and lower MCA PI MoM and CPR MoM. Regarding STV, a significant effect of low STV on NICU admission was found. 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.

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Publication History

Article published online:
07 October 2020