S Savchev1, F Figueras, R Cruz-Martinez, M Illa, F Botet, E Gratacos. 1. Department of Maternal-Fetal Medicine, Institute Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain.
Abstract
OBJECTIVE: To evaluate the risk of adverse perinatal outcome according to estimated fetal weight (EFW) in a cohort of term small-for-gestational-age (SGA) pregnancies with normal umbilical, fetal middle cerebral and maternal uterine artery Doppler indices. METHODS: A cohort of 132 term SGA fetuses with normal umbilical artery pulsatility index (PI), mean uterine artery PI and cerebroplacental ratio was compared to a control group of 132 appropriate-for-gestational-age babies, matched by gestational age at delivery. The capacity of the EFW percentile to predict Cesarean delivery, Cesarean delivery for non-reassuring fetal status (NRFS), neonatal acidosis and days of neonatal hospitalization was analyzed. RESULTS: As a whole, SGA fetuses with normal Doppler findings did not show a statistically significant difference for intrapartum Cesarean delivery (22.0 vs. 15.9%; P = 0.21) and neonatal acidosis (3.3 vs. 1.5%; P = 0.30), but had significantly higher risk for Cesarean delivery for NRFS (15.9 vs. 5.3%; P < 0.01) and longer neonatal hospitalization (1.39 vs. 0.87 days; P < 0.05) than did controls. SGA fetuses with EFW < 3(rd) centile had a significantly higher incidence of intrapartum Cesarean delivery (30.0 vs. 15.3%; P = 0.04), Cesarean delivery for NRFS (25.0 vs. 8.3%; P < 0.01) and longer neonatal hospitalization (2.0 vs. 0.9 days; P < 0.01) than those with EFW ≥ 3(rd) centile. SGA cases with EFW ≥ 3(rd) centile had perinatal outcomes similar to those of controls with normal EFW. CONCLUSION: Among SGA fetuses with normal placental and cerebral Doppler ultrasound findings, EFW < 3(rd) centile discriminates between those with a higher risk for adverse perinatal outcome and those with outcomes similar to those of normally grown fetuses.
OBJECTIVE: To evaluate the risk of adverse perinatal outcome according to estimated fetal weight (EFW) in a cohort of term small-for-gestational-age (SGA) pregnancies with normal umbilical, fetal middle cerebral and maternal uterine artery Doppler indices. METHODS: A cohort of 132 term SGA fetuses with normal umbilical artery pulsatility index (PI), mean uterine artery PI and cerebroplacental ratio was compared to a control group of 132 appropriate-for-gestational-age babies, matched by gestational age at delivery. The capacity of the EFW percentile to predict Cesarean delivery, Cesarean delivery for non-reassuring fetal status (NRFS), neonatal acidosis and days of neonatal hospitalization was analyzed. RESULTS: As a whole, SGA fetuses with normal Doppler findings did not show a statistically significant difference for intrapartum Cesarean delivery (22.0 vs. 15.9%; P = 0.21) and neonatal acidosis (3.3 vs. 1.5%; P = 0.30), but had significantly higher risk for Cesarean delivery for NRFS (15.9 vs. 5.3%; P < 0.01) and longer neonatal hospitalization (1.39 vs. 0.87 days; P < 0.05) than did controls. SGA fetuses with EFW < 3(rd) centile had a significantly higher incidence of intrapartum Cesarean delivery (30.0 vs. 15.3%; P = 0.04), Cesarean delivery for NRFS (25.0 vs. 8.3%; P < 0.01) and longer neonatal hospitalization (2.0 vs. 0.9 days; P < 0.01) than those with EFW ≥ 3(rd) centile. SGA cases with EFW ≥ 3(rd) centile had perinatal outcomes similar to those of controls with normal EFW. CONCLUSION: Among SGA fetuses with normal placental and cerebral Doppler ultrasound findings, EFW < 3(rd) centile discriminates between those with a higher risk for adverse perinatal outcome and those with outcomes similar to those of normally grown fetuses.
Authors: D Kabiri; R Romero; D W Gudicha; E Hernandez-Andrade; P Pacora; N Benshalom-Tirosh; D Tirosh; L Yeo; O Erez; S S Hassan; A L Tarca Journal: Ultrasound Obstet Gynecol Date: 2020-02 Impact factor: 7.299
Authors: Christoph C Lees; Roberto Romero; Tamara Stampalija; Andrea Dall'Asta; Greggory A DeVore; Federico Prefumo; Tiziana Frusca; Gerard H A Visser; John C Hobbins; Ahmet A Baschat; Caterina M Bilardo; Henry L Galan; Stuart Campbell; Dev Maulik; Francesc Figueras; Wesley Lee; Julia Unterscheider; Herbert Valensise; Fabricio Da Silva Costa; Laurent J Salomon; Liona C Poon; Enrico Ferrazzi; Giancarlo Mari; Giuseppe Rizzo; John C Kingdom; Torvid Kiserud; Kurt Hecher Journal: Am J Obstet Gynecol Date: 2022-01-10 Impact factor: 10.693
Authors: Russell L Deter; Wesley Lee; Haleh Sangi-Haghpeykar; Adi L Tarca; Lami Yeo; Roberto Romero Journal: J Matern Fetal Neonatal Med Date: 2014-07-11
Authors: Andrea Dall'Asta; Valentina Brunelli; Federico Prefumo; Tiziana Frusca; Christoph C Lees Journal: Matern Health Neonatol Perinatol Date: 2017-01-18
Authors: So Hyun Shim; Haeng Jun Jeon; Hye Jin Ryu; So Hyun Kim; Seung Gi Min; Min Kyu Kang; Hee Jin Park; Dong Hyun Cha Journal: Medicine (Baltimore) Date: 2021-02-26 Impact factor: 1.817