Document Detail

Is there any relation between development of persistent non-reassuring fetal heart rate pattern and acutely increased uterine artery vascular flow resistance during dinoprostone use in prolonged pregnancies?
MedLine Citation:
PMID:  19562559     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate the relation between changes in Doppler parameters of fetal and uterine arteries and development of persistent non-reassuring fetal heart rate (FHR) pattern during induction of labor with dinoprostone (Propess) in pregnancies at >or=41 weeks gestation. DESIGN: Prospective cohort study. SETTING: Etlik Zubeyde Hanim Women's Hospital, Turkey. SAMPLE: One hundred forty-one prolonged pregnancies. METHODS: Doppler parameters of umbilical, middle cerebral, and uterine arteries were measured before and 4-6 hours after dinoprostone application between uterine contractions. Non-reassuring FHR pattern and persistent non-reassuring FHR pattern criteria were defined based on NICE 2007 guidelines. Women with successful spontaneous vaginal delivery were recruited as a control group (n=108), while women who underwent cesarean delivery due to persistent non-reassuring FHR pattern were recruited as a study group (n=15). MAIN OUTCOME MEASURES: Prediction of non-reassuring FHR pattern with Doppler analysis of uterine and fetal arteries. RESULTS: After dinoprostone application there was significant enhancement in uterine artery resistance index (RI) in the study group compared to the control group (p=0.002). Receiver operating characteristics curve analysis identified a uterine artery RI increase value of 0.11 as the optimal threshold for prediction of persistent non-reassuring FHR pattern with 73.3% sensitivity and 69.4% specificity. Logistic regression analysis demonstrated that an increase in the uterine artery RI was predictive for persistent non-reassuring FHR pattern (odds ratio (OR) 4.97; 95% CI 1.5-16.8). CONCLUSION: Acute increase in uterine artery RI due to dinoprostone use may end with persistent non-reassuring FHR pattern in prolonged pregnancies. This may allow earlier prediction of persistent non-reassuring FHR pattern development and risk assessment.
Deniz Karcaaltincaba; Derya Akdag; Omer Kandemir; Serdar Yalvac; Emine Seda Guvendag Guven; Ali Haberal
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  88     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-24     Completed Date:  2009-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  894-900     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Hospital, Ankara, Turkey.
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MeSH Terms
Administration, Intravaginal
Cohort Studies
Delayed-Action Preparations
Dinoprostone / administration & dosage,  pharmacology*
Heart Rate, Fetal / drug effects*
Labor, Induced*
Middle Cerebral Artery / drug effects,  physiopathology,  ultrasonography
Oxytocics / administration & dosage,  pharmacology*
Pregnancy, Prolonged / physiopathology*,  therapy,  ultrasonography
Umbilical Arteries / drug effects,  physiopathology,  ultrasonography
Uterus / blood supply,  drug effects,  ultrasonography
Vascular Resistance / drug effects*
Young Adult
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Oxytocics; 363-24-6/Dinoprostone

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

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