CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(09): 859-865
DOI: 10.1055/a-0659-6873
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Foetal Doppler Parameters as a Prognostic Marker Before Induction of Labour

Article in several languages: English | deutsch
Peter Widschwendter
Frauenklinik, Klinikum der Universität Ulm, Ulm, Germany
,
Krisztian Lato
Frauenklinik, Klinikum der Universität Ulm, Ulm, Germany
,
Thomas W. P. Friedl
Frauenklinik, Klinikum der Universität Ulm, Ulm, Germany
,
Wolfgang Janni
Frauenklinik, Klinikum der Universität Ulm, Ulm, Germany
,
Ulrike Friebe-Hoffmann
Frauenklinik, Klinikum der Universität Ulm, Ulm, Germany
› Author Affiliations
Further Information

Publication History

received 01 August 2017
revised 17 June 2018

accepted 17 July 2018

Publication Date:
14 September 2018 (online)

Abstract

Introduction The value of foetal Doppler ultrasonography before induction of labour for prognostic assessment of the duration of labour and foetal outcome is presented.

Patients and Methods Doppler ultrasound of the foetal middle cerebral artery (MCA) and of the umbilical artery (UA) was performed in addition to evaluation of the Bishop score in 49 women around the expected date of confinement (38 + 0 – 42 + 0 weeks of gestation) prior to planned pharmacological induction of labour. These parameters were studied using non-parametric statistical methods for associations with the duration of induction until delivery, the mode of delivery and foetal outcome.

Results The resistance index (RI) of the MCA (rs = 0.547, p < 0.001), but not the RI of the UA (rs = − 0.055, p = 0.707) correlated positively with the duration of induction. Moreover, a negative correlation was found between the RI of the UA and the babyʼs arterial cord pH at birth (rs = − 0.287, p = 0.046). No differences in the RI of MCA or UA were found between babies born vaginally and those delivered by secondary section.

Conclusion The present data show that Doppler measurement of the foetal MCA and UA before pharmacological induction of labour at term can be a further parameter for prognostic estimation of the duration and success of induction and of foetal outcome in addition to the established Bishop score.

 
  • References/Literatur

  • 1 Durham L, Veltman L, Davis P. et al. Standardizing criteria for scheduling elective labor inductions. MCN Am J Matern Child Nurs 2008; 33: 159-165
  • 2 Bonsack CF, Lathrop A, Blackburn M. Induction of labor: update and review. J Midwifery Womens Health 2014; 59: 606-615
  • 3 Bishop EH. Pelvic Scoring for Elective Induction. Obstet Gynecol 1964; 24: 266-268
  • 4 Kolkman DG, Verhoeven CJ, Brinkhorst SJ. et al. The Bishop score as a predictor of labor induction success: a systematic review. Am J Perinatol 2013; 30: 625-630
  • 5 Severi FM, Boni C, Bruni L. et al. The increase of blood flow in the fetal middle cerebral artery correlates with the onset of labor at term. Reprod Sci 2008; 15: 584-590
  • 6 Gembruch U, Hecher K, Steiner H. Ultraschalldiagnostik in Geburtshilfe und Gynäkologie. 2nd ed.. ed. Berlin: Springer-Verlag; 2018
  • 7 Acharya G, Wilsgaard T, Berntsen GK. et al. Reference ranges for serial measurements of umbilical artery Doppler indices in the second half of pregnancy. Am J Obstet Gynecol 2005; 192: 937-944
  • 8 Ebbing C, Rasmussen S, Kiserud T. Middle cerebral artery blood flow velocities and pulsatility index and the cerebroplacental pulsatility ratio: longitudinal reference ranges and terms for serial measurements. Ultrasound Obstet Gynecol 2007; 30: 287-296
  • 9 Schneider A, Hommel G, Blettner M. Linear regression analysis: part 14 of a series on evaluation of scientific publications. Dtsch Arztebl Int 2010; 107: 776-782
  • 10 Tabachnick BG, Fidell LS. Using multivariate statistics. 6th ed. Boston: Pearson Education; 2013
  • 11 Bel-Ange A, Harlev A, Weintraub AY. et al. Waiting for postterm in healthy women, is it an accident waiting to happen?. J Matern Fetal Neonatal Med 2013; 26: 779-782
  • 12 [Anonym] WHO Recommendations for Induction of Labour. Geneva: WHO; 2011
  • 13 Stuck D, Bauer EC, Widschwendter P. et al. Geburtseinleitung mit Misoprostol: außerordentliche Heterogenität in Deutschland. Z Geburtshilfe Neonatol 2013; 217: Po06_7
  • 14 Laughon SK, Zhang J, Troendle J. et al. Using a simplified Bishop score to predict vaginal delivery. Obstet Gynecol 2011; 117: 805-811
  • 15 Reis FM, Gervasi MT, Florio P. et al. Prediction of successful induction of labor at term: role of clinical history, digital examination, ultrasound assessment of the cervix, and fetal fibronectin assay. Am J Obstet Gynecol 2003; 189: 1361-1367
  • 16 Rozenberg P, Goffinet F, Hessabi M. Comparison of the Bishop score, ultrasonographically measured cervical length, and fetal fibronectin assay in predicting time until delivery and type of delivery at term. Am J Obstet Gynecol 2000; 182: 108-113
  • 17 Gonen R, Degani S, Ron A. Prediction of successful induction of labor: comparison of transvaginal ultrasonography and the Bishop score. Eur J Ultrasound 1998; 7: 183-187
  • 18 Yagel S, Anteby E, Lavy Y. et al. Fetal middle cerebral artery blood flow during normal active labour and in labour with variable decelerations. Br J Obstet Gynaecol 1992; 99: 483-485
  • 19 Schäffer L. Geburtseinleitung. In: Dimpfl T et al., Hrsg. Weiterbildung Gynäkologie und Geburtshilfe. Berlin, Heidelberg: Springer; 2015
  • 20 Acharya G, Sonesson SE, Flo K. et al. Hemodynamic aspects of normal human feto-placental (umbilical) circulation. Acta Obstet Gynecol Scand 2016; 95: 672-682
  • 21 Maged AM, Abdelhafez A, Al Mostafa W. et al. Fetal middle cerebral and umbilical artery Doppler after 40 weeks gestational age. J Matern Fetal Neonatal Med 2014; 27: 1880-1885
  • 22 Alfirevic Z, Stampalija T, Medley N. Fetal and umbilical Doppler ultrasound in normal pregnancy. Cochrane Database Syst Rev 2015; (04) CD001450 DOI: 10.1002/14651858.CD001450.pub4.
  • 23 Alfirevic Z, Stampalija T, Gyte GM. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database Syst Rev 2013; (11) CD007529 DOI: 10.1002/14651858.CD007529.pub3.