Waiting for postterm in healthy women, is it an accident waiting to happen?

Bel-Ange, Anat; Harlev, Avi; Weintraub, Adi Y.

doi:10.3109/14767058.2012.759207

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…The duration of pregnancy, calculated from the first day of the last menstrual period, is approximately 40 weeks. Prolongation of pregnancy beyond the estimated date of delivery (EDD) harbours the risk of placental insufficiency with the consequent risk of intrauterine foetal death 11 , 12 .…”

Section: Discussionmentioning

confidence: 99%

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Foetal Doppler Parameters as a Prognostic Marker Before Induction of Labour

Widschwendter

Látó

Friedl

et al. 2018

Geburtshilfe Frauenheilkd

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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.

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Section: Discussionmentioning

confidence: 99%

“…40 Wochen. Eine längere Übertragung über den errechneten Entbindungszeitpunkt (ET) hinaus birgt die Gefahr einer Plazentainsuffizienz mit dem konsekutiven Risiko eines intrauterinen Fruchttodes 11 , 12 .…”

Section: Diskussionunclassified

Foetal Doppler Parameters as a Prognostic Marker Before Induction of Labour

Widschwendter

Látó

Friedl

et al. 2018

Geburtshilfe Frauenheilkd

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“…Estudos indicam a nuliparidade, obesidade, idade materna avançada e etnicidade como os principais fatores de risco do nascimento pós-termo 1,4,5 . Entretanto, a proporção de nascimentos pós-termo é extremamente variável entre os países europeus (variou de 0,4% na Bélgica e na Áustria a mais de 7% na Dinamarca e na Suécia) 6 e parece estar mais correlacionada a diretrizes clínicas locais da atenção ao parto e nascimento.…”

Section: Introductionunclassified

Magnitude e características dos nascimentos termo tardio e pós-termo e complicações maternas e neonatais no Brasil, 2011

2022

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Este estudo analisou o nascimento termo tardio e pós-termo, avaliando o perfil materno, suas características e as complicações maternas e neonatais. Foram selecionados 23.610 bebês do estudo Nascer no Brasil (2011), sendo realizada uma análise descritiva da população de estudo. A associação entre o nascimento termo tardio e pós-termo e seus desfechos foi efetuada pela utilização de regressões logísticas (valor de p < 0,05). A prevalência encontrada foi de 7,4% para o termo tardio e de 2,5% para o pós-termo, tendo ambos sido mais frequentes nas regiões Norte e Nordeste, em adolescentes, mulheres negras, de baixa escolaridade, multíparas, atendidas no setor público. As gestações termo tardio tiveram maior chance de indução do parto vaginal (OR = 2,02; IC95%: 1,67-2,45), de cesariana (OR = 1,32; IC95%: 1,16-1,52), de laceração grave (OR = 3,75; IC95%: 1,36-10,36) e de uso oxigenoterapia para os recém-nascidos (OR = 1,52; IC95%: 1,02-2,26). Nas gestações pós-termo, os recém-nascidos tiveram menor chance de amamentação ao nascer (OR = 0,74; IC95%: 0,56-0,97) e durante a hospitalização (OR = 0,62; IC95%: 0,40-0,97) e maior chance de nascerem pequenos para a idade gestacional (OR = 4,01; IC95%: 2,83-5,70). Os resultados utilizando somente a ultrassonografia como medida da idade gestacional confirmaram os achados anteriores. Gestações termo tardio e pós-termo ocorrem com maior frequência nas regiões Norte e Nordeste e em mulheres com maior vulnerabilidade social, associando-se a complicações maternas e neonatais.

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“…Studies in recent years regard postterm pregnancy as a serious obstetric complication much like fertility issues, diabetes mellitus, hypertensive disorders, and intrauterine retardation; it is also emphasised that postterm pregnancy alone is an independent perinatal mortality risk factor (8).…”

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confidence: 99%

The relationship between doppler parameters and perinatal outcomes in postterm pregnancies.

2014

J Turgut Ozal Med Cent

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Aim: The aim of the study is to identify the relationship between doppler parameters and perinatal outcomes in post-term pregnancies. Material and Method: 101 pregnant women (37-41 weeks, control group; n:51 and ≥41 weeks, study group, n:50) were included in the study. We performed umblical artery and middle cerebral artery blood flow velocity waveform (pulsatility index, resistivity index, and systole/diastole ratio) analyses for our patients. Results: The mean value of the umbilical artery resistivity index was significantly higher in the study group than the control group while the mean value of the umbilical artery pulsatility index was significantly lower in the study group. The middle cerebral artery resistivity index was significantly lower in the study group, which was consistent with preferantial perfusion of the brain. We also found decreased ratios of middle cerebral artery resistivity index in umblical artery resistivity index in the study group (1.11) compared with the control group (1.25). These findings can be interpreted in favor of worse perinatal outcomes in the study group while the increased adverse perinatal outcome rates (%64) in the study group supports this view. The ratio of middle cerebral artery resistivity index to umblical artery resistivity index <1.155 can be used as a sign of adverse perinatal outcomes in prolonged pregnancies with a senstivity of %76.6 and a specificity rate of %85.2. Conclusion: Doppler ultrasonography can be used for reducing perinatal mortality and morbidity of prolonged pregnancies. Key Words: Doppler; Postterm Pregnancy; Perinatal Mortality; Perinatal Morbidity. Uzamış Gebeliklerde Doppler Ultrasonografi Bulguları ile Perinatal Sonuçlar Arasındaki İlişkiÖzet Amaç: Uzamış gebeliklerde doppler ultrasonografi bulguları ile perinatal sonuçlar arasındaki ilişkiyi incelemek amaçlandı. Gereç ve Yöntem: Bu çalışmaya 37-41 gebelik haftası arasındaki 51 (kontrol grubu), ≥41 gebelik haftasındaki 50 hasta (çalışma grubu) dahil edildi. Renkli doppler ultrasonografide umblikal arter ve orta serebral artere ait akım paternleri değerlendirilerek doppler indeksleri ölçüldü. Bu damarlarda akımı değerlendirmek için, pulsatilite indeksi, rezistivite indeksi ve sistol/diastol oranı ölçüldü. Bulgular: Uzamış gebeliklerde, kontrol grubuna göre, umblikal arter rezistivite indeks değeri daha yüksek, pulsatilite indeks değeri daha düşük bulundu. Uzamış gebeliklerde ölçülen orta serebral arter rezistivite indeks ortanca değeri kontrol grubuna göre anlamlı derecede daha düşüktü ve bu, beyin için oluşturulan koruma mekanizması lehine bir bulgu olarak değerlendirildi. Orta serebral arter rezistivite indeks / umblikal arter rezistivite indeks ortanca değeri çalışma grubunda (1.11) kontrol grubununkine (1.25) göre istatistiksel olarak daha küçüktü, nitekim uzamış gebelikler için kötü perinatal sonuç %64 sıklıkla kontrol grubuna göre istatistiksel olarak anlamlı derecede daha fazla bulundu. Uzamış gebeliklerde kötü perinatal sonucu öngörmede orta serebral arter rezistivite indeks / ...

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Waiting for postterm in healthy women, is it an accident waiting to happen?

Abstract: Although postterm pregnancies were less likely to be associated with obstetrical risk factors and complications such as fertility treatments, diabetes mellitus, hypertensive disorders, IUGR and PROM, postterm is an independent risk factor for perinatal mortality.

Cited by 6 publications

References 21 publications

Foetal Doppler Parameters as a Prognostic Marker Before Induction of Labour

Foetal Doppler Parameters as a Prognostic Marker Before Induction of Labour

Magnitude e características dos nascimentos termo tardio e pós-termo e complicações maternas e neonatais no Brasil, 2011

The relationship between doppler parameters and perinatal outcomes in postterm pregnancies.

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