Impact of Intended Mode of Delivery on Outcomes in Preterm Growth-Restricted Fetuses.
Am J Perinatol
; 35(7): 605-610, 2018 06.
Article
en En
| MEDLINE
| ID: mdl-29183094
ABSTRACT
BACKGROUND:
Scheduled cesarean is frequently performed for fetal growth restriction due to concerns for fetal intolerance of labor.OBJECTIVE:
We compared neonatal outcomes in preterm growth-restricted fetuses by intended mode of delivery. STUDYDESIGN:
We performed a retrospective cohort study of indicated preterm births with prenatally diagnosed growth restriction from 2011 to 2014 at a single institution. Patients were classified by intended mode of delivery. The primary outcome was a composite of adverse neonatal outcomes, including perinatal death, cord blood acidemia, chest compressions during neonatal resuscitation, seizures, culture-proven sepsis, necrotizing enterocolitis, and grade III-IV intraventricular hemorrhage. Secondary analysis was performed examining the impact of umbilical artery Dopplers.RESULTS:
Of 101 fetuses with growth restriction, 75 underwent planned cesarean deliveries. Of those induced, 46.2% delivered vaginally. Delivery by scheduled cesarean was not associated with a decreased risk of the composite outcome (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 0.45-5.78), even when only those with abnormal umbilical artery Dopplers were considered (aOR, 2.8; 95% CI, 0.40-20.2).CONCLUSION:
In this cohort, planned cesarean was not associated with a reduction in neonatal morbidity, even when considering only those with abnormal umbilical artery Dopplers. In otherwise appropriate candidates for vaginal delivery, fetal growth restriction should not be considered a contraindication to trial of labor.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arterias Umbilicales
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Resultado del Embarazo
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Parto Obstétrico
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Retardo del Crecimiento Fetal
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Enfermedades del Prematuro
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Newborn
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Pregnancy
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Perinatol
Año:
2018
Tipo del documento:
Article