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    
Abstract/OtherAbstract:
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.
Authors:
Deniz Karcaaltincaba; Derya Akdag; Omer Kandemir; Serdar Yalvac; Emine Seda Guvendag Guven; Ali Haberal
Related Documents :
12797069 - Doppler ultrasonography in early pregnancy does not predict adverse pregnancy outcome.
13679939 - Perinatal outcome following amniotic septostomy in chronic ttts is independent of place...
2488669 - Significance of velocimetry as a monitor of fetal assessment and management.
1661309 - Insulin induced fetal hypoglycaemia and fetal and maternal plasma prostaglandin concent...
15692199 - Analysis of renal artery hemodynamics in normal fetuses using the color doppler method.
9389829 - The predictive value of uterine artery blood flow measurements for uterine receptivity ...
18355989 - Buprenorphine and methadone treatment of opiate dependence during pregnancy: comparison...
15982499 - Congenital heart disease in a population of dizygotic twins: an echocardiographic study.
18043569 - Twin pregnancy: not only a medical event.
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    
Affiliation:
Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Hospital, Ankara, Turkey. denizaltincaba@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Administration, Intravaginal
Adult
Cohort Studies
Delayed-Action Preparations
Dinoprostone / administration & dosage,  pharmacology*
Female
Heart Rate, Fetal / drug effects*
Humans
Labor, Induced*
Middle Cerebral Artery / drug effects,  physiopathology,  ultrasonography
Oxytocics / administration & dosage,  pharmacology*
Pregnancy
Pregnancy, Prolonged / physiopathology*,  therapy,  ultrasonography
Umbilical Arteries / drug effects,  physiopathology,  ultrasonography
Uterus / blood supply,  drug effects,  ultrasonography
Vascular Resistance / drug effects*
Young Adult
Chemical
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


Previous Document:  Subtotal ear amputation with a very narrow pedicle: a case report and review of the literature.
Next Document:  Cryopreserved blastocysts have a lower implantation but an equal live birth rate as compared to fres...