Assessment of the Relationship Between Delivery Route, Umbilical Cord pH and Fetal Complications With Doppler Parameters Measured Prior to Induction of Labor at Term Pregnancies.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Term Pregnancy
- Sponsor
- Istanbul Medeniyet University
- Enrollment
- 145
- Locations
- 1
- Primary Endpoint
- APGAR score at 5 minutes
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
Term pregnancies within their 37-41 gestational week, who were planned to undergo induction of labor, were included in the study. Prior to initiation of the induction of labor, all included pregnant women underwent an assessment of Doppler flow indices, which included fetal umblical artery PI (pulsatility index) and fetal middle cerebral artery (MCA:Middle cerebral arter) PI. Cerebroplacental Ratio (CPR) was calculated by dividing MCA PI value to umbilical artery PI (MCA PI/UA PI=CPR).Included pregnant women were categorized as Group 1 and Group 2, which comprised of those with CPR value below 1.0 and above 1.0, respectively. Route of delivery and fetal complications, described as umbilical cord pH<7.20, APGAR score at 5 minutes <7, meconium aspiration syndrome, newborn intensive care unit admission, neonatal sepsis and neonatal death.
Detailed Description
Term pregnancies within their 37-41 gestational week, who were planned to undergo induction of labor, were included in the study. Prior to initiation of the induction of labor, all included pregnant women underwent an assessment of Doppler flow indices, which included fetal umblical artery PI (pulsatility index) and fetal middle cerebral artery (MCA:Middle cerebral arter) PI. Cerebroplacental Ratio (CPR) was calculated by dividing MCA PI value to umbilical artery PI (MCA PI/UA PI=CPR).Included pregnant women were categorized as Group 1 and Group 2, which comprised of those with CPR value below 1.0 and above 1.0, respectively. All women who were considered appropriate for induction of labor were performed an pelvic examination and their Bishop scores were calculated. Those with a Bishop score equal to or below 5 were included in the study. Vaginal misoprostol (prostoglandin E1, 25 mcg) and dinoproston (prostoglandin E2, 10 mg) were used for induction of labor. Repeat doses were implemented in case of insufficient cervical ripening. Oxytocin was not used at the initial stages of labour, while it was used at the latter stages when necessary. Route of delivery and fetal complications, described as umbilical cord pH\<7.20, APGAR score at 5 minutes \<7, meconium aspiration syndrome, newborn intensive care unit admission, neonatal sepsis and neonatal death.
Investigators
Özkan Özdamar
M.D., Principal Investigator, Clinical Investigator of OB&GYN
Istanbul Medeniyet University
Eligibility Criteria
Inclusion Criteria
- •Term pregnancies between 37 and 41 gestational weeks Pregnancies destined to induction of labor
Exclusion Criteria
- •history of uterine scar, nonverteks presentation, multiple pregnancies, use of vacuum of forceps at delivery, shoulder dystocia, confirmed fetal structural or chromosomal anomalies
Outcomes
Primary Outcomes
APGAR score at 5 minutes
Time Frame: Postpartum 5 minutes
APGAR score determined by the pediatrician at postpartum 5 minutes
Newborn intensive care unit administration
Time Frame: Within postpartum 1 month period
Newborn intensive care unit administration, due to a variety of conditions, which were established by pediatrician
Meconium aspiration syndrome
Time Frame: Within postpartum two weeks
Meconium aspiration syndrome diagnosed by the pediatrician, either clinically or by thorax X-ray film.
Neonatal sepsis
Time Frame: Within postpartum 1 month period
Neonatal sepsis diagnosed by the pediatrician
Neonatal death
Time Frame: Within postpartum 1 month period
Neonatal death
Umblical arter pH
Time Frame: Within 1-3 minutes following delivery
Umbilical cord blood sampling just after the delivery of the newborn and pH measurement
Secondary Outcomes
- Route of delivery(At the time of delivery)