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- W2977894734 abstract "Identification of fetuses at risk of intrapartum compromise remains challenging. We investigated the association between estimated fetal weight (EFW), AC growth velocity (ACGV) and cerebroplacental ratio (CPR) in the third trimester as predictors of intrapartum fetal compromise (IFC). An unselected cohort of 9917 singleton fetuses had a universal 36 week scan in a single tertiary referral centre (2016-2018). EFW, ACGV and CPR were assessed and revealed to responsible clinicians. The ACGV was defined as the Z-score AC difference between 20 and 36 weeks. Our outcome was Caesarean or instrumental delivery for IFC. Univariate and multivariate logistic regression analyses were used to assess the association between EFW, ACGV and CPR, both as continuous and binary variables, and IFC. EFW< 10th centile, EFW> 90th centile, ACGV< 10th centile, ACGV> 90th centile and CPR< 5th centile were defined as abnormal. Multivariate logistic regression analysis was also performed to identify, and adjust for, potential confounders. On multivariate logistic regression, both ACGV (odds ratio (OR) 1.14; 95% confidence interval (CI), 1.05-1.24) and CPR (OR 0.82; 95% CI, 0.72-0.94) as continuous variables were independently associated with IFC. EFW< 10th centile (OR 1.75; 95% CI, 1.10-2.77), EFW> 90th centile (OR 1.90; 95% CI, 1.04-3.46), ACGV> 90th centile (OR 1.53; 95% CI, 1.16-2.00) and CPR< 5th centile (OR 1.72; 95% CI, 1.33-2.23) were independent predictors for IFC. ACGV< 10th centile (OR 0.80; 95% CI, 0.63-1.02) showed no association with IFC. Potential confounders such as nulliparity (OR 3.92; 95%, CI 3.36-4.58), induction of labour (OR 1.34; 95% CI, 1.15-1.56), gestational age at delivery (OR 1.02; 95% CI, 1.01-1.03) and epidural use in labour (OR 2.20; 95% CI, 1.91-2.53) were independently associated with IFC. EFW, ACGV and CPR in the third trimester are independent predictors of IFC. These markers have the potential to be used for clinical decision making including continuous fetal monitoring in labour, timing and mode of delivery." @default.
- W2977894734 created "2019-10-10" @default.
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- W2977894734 date "2019-09-30" @default.
- W2977894734 modified "2023-09-27" @default.
- W2977894734 title "OC15.03: Identification of intrapartum fetal compromise using universal third trimester ultrasonography" @default.
- W2977894734 doi "https://doi.org/10.1002/uog.20520" @default.
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