Cerebroplacental Ratio Prediction of Intrapartum Fetal Compromise according to the Interval to Delivery.

Fecha de publicación: 01/01/2022 Fecha Ahead of Print: 07/06/2022

Autores de IIS La Fe

José Morales Roselló

Autor
Gabriela Alejandra Loscalzo

Autor
Alfredo José Perales Marín

Autor

Participantes ajenos a IIS La Fe

Khalil, Asma
Buongiorno, Silvia
Brik, Maia
Mendoza, Manel
Di Fabrizio, Carolina
Scarinci, Elisa
Salvi, Silvia
Lanzone, Antonio

Grupos

Medicina Reproductiva

Investigador Principal

José Morales Roselló

Abstract

Introduction: A controversy exists about the accuracy of the cerebroplacental ratio (CPR) for the prediction of cesarean section for intrapartum fetal compromise (CS-IFC). Our aim was to evaluate whether the interval to delivery modifies the accuracy of CPR either as a single marker or combined with estimated fetal weight centile (EFWc), type of labor onset (TLO), and other clinical variables. Methods: This was a multicenter retrospective study of 5,193 women with singleton pregnancies who underwent an ultrasound scan at 35(+0)-41(+0) weeks and gave birth within 1 month of examination, at any of the participating hospitals in Spain, UK, and Italy. CS-IFC was diagnosed in case of an abnormal intrapartum fetal heart rate or intrapartum fetal scalp pH <7.20, requiring urgent cesarean section. The diagnostic ability of CPR in multiples of the median (CPR MoM) was evaluated at different intervals to delivery, alone and combined with EFWc, TLO, and other pregnancy data such as maternal age, maternal body mass index, parity, and fetal sex, for the prediction of CS-IFC by means of ROC curves and logistic regression analysis. Results: The predictive ability of CPR MoM for CS-IFC worsened with the interval to delivery. In general, the best prediction was obtained prior to labor and by adding information related to EFWc and TLO (AUC 0.71 [95% CI: 0.64-0.79], 0.73 [95% CI: 0.66-0.80], and 0.75 [95% CI: 0.69-0.81]; p < 0.0001). Addition of more clinical data did not improve prediction. In addition, results did not vary when only cases with spontaneous onset of labor were studied. Conclusion: CPR MoM prediction of CS-IFC at the end of pregnancy worsens with the interval to delivery. Accordingly, it should be done in the short term and considering EFWc and TLO. (C) 2022 S. Karger AG, Basel

Datos de la publicación

ISSN/ISSNe:: 1015-3837, 1421-9964
Tipo:: Article
Páginas:: 196-205
DOI:: 10.1159/000525162
PubMed:: 35671735
Factor de Impacto:: 0,935 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Morales-Rosello, Jose:: Hosp Univ & Politecn La Fe, Serv Obstetricia & Ginecol, Valencia, Spain

Univ Valencia, Dept Pediat Obstetricia & Ginecol, Valencia, Spain
Khalil, Asma:: St George Hosp, Fetal Med Unit, S, London, England
Loscalzo, Gabriela:: Hosp Univ & Politecn La Fe, Serv Obstetricia & Ginecol, Valencia, Spain
Buongiorno, Silvia:: Fdn Policlin Univ A Gemelli IRCCS, Dept Sci Salute Donna Bambino & Sanita Pubbl, Rome, Italy
Brik, Maia:: Hosp Univ Vall dHebron, Maternal Fetal Med Dept, Obstet Dept, Barcelona, Spain

Univ Autonoma Barcelona, Dept Pediat Obstetricia Ginecol Med Prevent & Sal, Bellaterra, Spain
Mendoza, Manel:: Hosp Univ Vall dHebron, Maternal Fetal Med Dept, Obstet Dept, Barcelona, Spain

Univ Autonoma Barcelona, Dept Pediat Obstetricia Ginecol Med Prevent & Sal, Bellaterra, Spain
Di Fabrizio, Carolina:: St George Hosp, Fetal Med Unit, S, London, England
Scarinci, Elisa:: Fdn Policlin Univ A Gemelli IRCCS, Dept Sci Salute Donna Bambino & Sanita Pubbl, Rome, Italy
Salvi, Silvia:: Fdn Policlin Univ A Gemelli IRCCS, Dept Sci Salute Donna Bambino & Sanita Pubbl, Rome, Italy
Lanzone, Antonio:: Fdn Policlin Univ A Gemelli IRCCS, Dept Sci Salute Donna Bambino & Sanita Pubbl, Rome, Italy
Perales Marin, Alfredo:: Hosp Univ & Politecn La Fe, Serv Obstetricia & Ginecol, Valencia, Spain

Univ Valencia, Dept Pediat Obstetricia & Ginecol, Valencia, Spain