Document Detail

Comparison of umbilical-artery velocimetry and cardiotocography for surveillance of small-for-gestational-age fetuses.
MedLine Citation:
PMID:  1357349     Owner:  NLM     Status:  MEDLINE    
Intrauterine growth retardation is associated with an increased risk of fetal asphyxia as well as greater perinatal morbidity and mortality. Ultrasound fetometry enables detection of fetuses that are small for gestational age. Doppler velocimetry of the umbilical artery has good predictive ability for fetal distress, but it is not yet clear whether it could replace cardiotocography in antenatal surveillance of small-for-gestational-age fetuses. We have done a randomised comparison of the two methods. At four obstetric departments in Sweden, women with fetuses found to be small on ultrasound examination at 31 completed weeks of pregnancy or later were randomly assigned to antenatal surveillance with either doppler velocimetry (doppler; 214) or cardiotocography (CTG; 212). Pregnancies in the doppler group were managed according to a protocol based on blood-flow classes deriving from the semiquantitative evaluation of umbilical-artery velocity waveforms; unless the pregnancy was complicated by any other disorder, no antenatal cardiotocography was done. By comparison with the CTG group, the doppler group had fewer monitoring occasions (mean 4.1 [SD 3.1] vs 8.2 [6.2], p < 0.01), antenatal hospital admissions (68 [31.3%] vs 97 [45.8%], p < 0.01), inductions of labour (22 [10.3%] vs 46 [21.7%], p < 0.01), emergency caesarean sections for fetal distress (11 [5.1] vs 30 [14.2%], p < 0.01), and admissions to neonatal intensive care (76 [35.5%] vs 92 [43.4%], p = 0.10). The groups did not differ in gestational age at birth, birthweight, Apgar scores, or total number of caesarean deliveries. Umbilical-artery doppler velocimetry of small-for-gestational-age fetuses allows antenatal monitoring and obstetric interventions to be aimed more precisely than does cardiotocography.
H Almström; O Axelsson; S Cnattingius; G Ekman; A Maesel; U Ulmsten; K Arström; K Marsál
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  340     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1992 Oct 
Date Detail:
Created Date:  1992-11-16     Completed Date:  1992-11-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  936-40     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, Danderyd's Hospital, Karolinska Institutet, Stockholm, Sweden.
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MeSH Terms
Apgar Score
Fetal Growth Retardation / diagnosis*
Infant, Newborn
Prospective Studies
Ultrasonography, Prenatal*
Umbilical Arteries
Comment In:
Lancet. 1992 Nov 21;340(8830):1294   [PMID:  1359354 ]
Lancet. 1992 Nov 28;340(8831):1348-9   [PMID:  1360054 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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