No abstract

Background: Increased fetal umbilical artery resistance can cause fetal hypoxia, redistribute fetal blood flow, dilate the middle cerebral artery, and reduce the cerebroplacental rate (CPR). CPR<1 is a danger sign of fetal hypoxia. Choosing the appropriate time for terminating a pregnancy with the most favorable pregnancy outcome and the short-term outcome of infants, based on the abnormal performance of the cord blood flow, is crucial. Methods: A total of 114 pregnant women with CPR < 1 who gave birth at Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from January 2015 to December 2019 were analyzed retrospectively. The age, height, and weight of the aforementioned pregnant women, as well as the gestational age when CPR<1 occurs for the first time, were recorded. The women were divided into two groups, based on pregnancy termination: the immediately terminated pregnancy group and the continued pregnancy group. The pregnancy outcomes, neonatal outcomes, and short-term outcome of the surviving infants in both groups were recorded and compared. Results: ① the pregnant women in the continued pregnancy group waited for an average period of 3 weeks prior to the termination of pregnancy beyond 32 weeks. The average weight of the newborn was 1429 g, which was significantly lower than that of the average newborn at the corresponding gestational age. In the continued pregnancy group, intrauterine death was reported in 18 cases (40.9%) and intrauterine death of one fetus in a twin pregnancy was reported in 2 cases. Intrauterine death occurred 2–33 day after CPR<1 (12.8 d on average) as determined. ② the incidence rates of neonatal asphyxia, neonatal pneumonia, neonatal sepsis, and neonatal anemia in the continued pregnancy group were significantly higher than those in the immediately terminated pregnancy group. ③ The proportions of children with autism spectrum disorder, motor development retardation, and growth retardation were slightly higher in the continued pregnancy group than in the immediately terminated pregnancy group; however, the difference was not statistically significant. Conclusion: Intrauterine hypoxia is considered severe when CPR<1. In this case, a cesarean section should be conducted immediately, and waiting may cause an increased risk of neurodevelopment disorder in children.

No abstract