Management of fetal growth restriction using the contraction stress test: a case-control study

Tanaka, Hiroaki; Furuhashi, Fumi; Toriyabe, Kuniaki; Matsumoto, Toshifumi; Magawa, Shoich; Nii, Masafumi; Watanabe, Junko; Tanaka, Kayo; Umekawa, Takashi; Kamimoto, Yuki; Ikeda, Tomoaki

doi:10.1080/14767058.2018.1461313

Cited by 4 publications

(5 citation statements)

References 12 publications

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“…The placenta is an organ with relatively low resistance and slow blood flow. Color Doppler ultrasound can neither detect the low-speed blood flow inside the placenta villi space nor identify the individual villi blood vessels [ 13 ]. Several large cohort studies have also indicated that conventional ultrasound changes are associated with low sensitivity and specificity in the FGR population [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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The Application Value of Three-Dimensional Power Doppler Ultrasound in Fetal Growth Restriction

Wang¹,

Li²,

Lei³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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In this study, the application value of three-dimensional power Doppler ultrasound (3D-PDU) in fetal growth restriction (FGR) is explored. The retrospective cohort study enrolled pregnant women (with a gestational week of 11–13 + 6 weeks) who received routine health care in the obstetrics and gynecology clinic of our hospital from January 2020 to January 2021. The placentae were scanned using 3D-PDU, and the subjects were followed up until delivery. The fetuses were divided into the control group (n = 322) and FGR group (n = 44) according to their birth weight. There was no significant difference in nuchal translucency (NT), crown-rump length (CRL), and placental volume (PV) during the first trimester between the two groups ( P > 0.05 ). Compared with the control group, the FGR group showed significantly lower levels of vascularisation index (VI), flow index (FI), and vascularisation flow index (VFI) and a higher incidence of fetal distress and neonatal asphyxia ( P < 0.05 ). The FGR group showed a longer gestational week at birth, a higher probability of cesarean section, and a lower 5-minute Apgar score than the control group ( P < 0.05 ). The VI, FI, and VFI of the control group were significantly higher than those of the FGR group. Pearson analysis showed that birth weight was positively correlated with VI and FI ( P < 0.05 ). 3D-PDU assesses the blood perfusion of the fetus and placenta in the first trimester and predicts the pregnancy outcome, which shows great potential in the early diagnosis of FGR.

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Section: Discussionmentioning

confidence: 99%

“…e placenta is an organ with relatively low resistance and slow blood flow. Color Doppler ultrasound can neither detect the low-speed blood flow inside the placenta villi space nor identify the individual villi blood vessels [13].…”

Section: Discussionmentioning

confidence: 99%

The Application Value of Three-Dimensional Power Doppler Ultrasound in Fetal Growth Restriction

Wang¹,

Li²,

Lei³

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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show abstract

“…Tanaka et al presented a case-control retrospective study about the efficacy of OCT in management of IUGR, having included 73 cases [8]. They found significant differences in oxygen saturation in the umbilical artery (UA) between the groups and concluded that OCT allows early intervention in cases of IUGR, which enables fetal acidemia and acidosis to be avoided.…”

Section: Discussionmentioning

confidence: 99%

The Present Utility of the Oxytocin Challenge Test—A Single-Center Study

Różańska-Walędziak

Czajkowski

Teliga-Czajkowska

2020

JCM

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Introduction: The oxytocin challenge test (OCT) used to be one of the most important tools in assessing fetal well-being before ultrasonography became prevalent. We show that, after modifying the classification of the results and the intervention algorithm, OCT can still be a useful tool in present-day obstetrics. Material and methods: The study included 318 OCTs performed in patients admitted to our department from 2010 to 2012. A modified classification of test results was introduced, dividing the results in four groups: I-negative, II-positive, III-non-diagnostic and type IV (fetal tachycardia or increased variability). The purpose of the study was to evaluate the clinical significance of OCT in assessing intrauterinal fetal well-being and predicting the necessity for ending the pregnancy. Results: A significant difference (p < 0.001) in the delivery method and the indications for cesarean sections (CS) was found between negative and positive OCT results. CS indicated by an abnormal fetal heart rate (FHR) pattern had to be performed in 40% of cases with positive OCT results, having constituted 84.6% of all CSs in this group. After negative OCTs, 12.8% pregnancies were ended by CS from FHR indications (62.3% of all the indications). Conclusions: A positive OCT result can be a valuable predictor of an abnormal fetal heart rate pattern after the test and during the delivery, as well as a higher probability of a CS from cardiotocography (CTG) indications, with positive predictive value (PPV) 0.50 and negative predictive value (NPV) 0.85.

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“…Repeated spontaneous decelerations indicate imminent delivery. Contraction stress tests may allow early intervention before fetal acidemia occurs and helps in the reduction in adverse outcome [ 42 ]. We did not find any difference in FHRM monitoring, likely because we intervened before the outcome worsened.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Tests in the Prediction of Neonatal Outcome in Early Placental Fetal Growth Restriction

et al. 2023

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Background and Objectives: Monitoring pregnancies with fetal growth restriction (FGR) presents a challenge, especially concerning the time of delivery in cases of early preterm pregnancies below 32 weeks. The aim of our study was to compare different diagnostic parameters in growth-restricted preterm neonates with and without morbidity/mortality and to determine sensitivity and specificity of diagnostic parameters for monitoring preterm pregnancies with early preterm fetal growth restriction below 32 weeks. Materials and Methods: Our clinical study evaluated 120 cases of early preterm deliveries, with gestational age ≤ 32 + 0 weeks, with prenatally diagnosed placental FGR. All the patients were divided into three groups of 40 cases each based on neonatal condition,: I—Neonates with morbidity/mortality (NMM); II—Neonates without morbidity with acidosis/asphyxia (NAA); III—Neonates without neonatal morbidity/acidosis/asphyxia (NWMAA). Results: Amniotic fluid index (AFI) was lower in NMM, while NWMAA had higher biophysical profile scores (BPS). UA PI was lower in NWMAA. NWMAA had higher MCA PI and CPR and fewer cases with CPR <5th percentile. NMM had higher DV PI, and more often had ductus venosus (DV) PI > 95th‰ or absent/reversed A wave, and pulsatile blood flow in umbilical vein (UV). The incidence of pathological fetal heart rate monitoring (FHRM) was higher in NMM and NAA, although the difference was not statistically significant. ROC calculated by defining a bad outcome as NMM and a good outcome as NAA and NWMAA showed the best sensitivity in DV PIi. ROC calculated by defined bad outcome in NMM and NAA and good outcome in NWMAA showed the best sensitivity in MCA PI. Conclusions: In early fetal growth restriction normal cerebral blood flow strongly predicts good outcomes, while pathological venous blood flow is associated with bad outcomes. In fetal growth restriction before 32 weeks, individualized expectant management remains the best option for the optimal timing of delivery.

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Management of fetal growth restriction using the contraction stress test: a case-control study

Cited by 4 publications

References 12 publications

The Application Value of Three-Dimensional Power Doppler Ultrasound in Fetal Growth Restriction

The Application Value of Three-Dimensional Power Doppler Ultrasound in Fetal Growth Restriction

The Present Utility of the Oxytocin Challenge Test—A Single-Center Study

Diagnostic Tests in the Prediction of Neonatal Outcome in Early Placental Fetal Growth Restriction

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