Factors Predicting Successful Vaginal Delivery Following Induction of Labor in Term Pregnancy v1

2021 ◽  
Author(s):  
Wirada Hansahiranwadee ◽  
Threebhorn Kamlungkuea ◽  
Jittima Manonai Bartlett
Keyword(s):  
Prediction Model ◽  
Vaginal Delivery ◽  
Gestational Age ◽  
Labor Induction ◽  
Induction Of Labor ◽  
Fetal Weight ◽  
Term Pregnancy ◽  
Individual Probability ◽  
History Of ◽  
Estimated Fetal Weight

Objective This study was proposed to evaluatefactors predicting successful vaginal delivery following labor induction and develop induction prediction model in term pregnancy among Thai pregnant women. Method We conducted a retrospective cohort study using electronic medical recordsof 23,833 deliveries from April 2010 - July 2021 at tertiary-level hospital in Bangkok, Thailand. Univariate regression was performed to identify association of individual parameters to successful vaginal delivery. Multiple logistic regression analysis of all possible variables from univariate analysis was performed to develop prediction model with statistically significant of p value < 0.05. Results Of thetotal 809 labor-induced pregnancies, the vaginal delivery rate was 56.6%. Among predicting variables, history of previous vaginal delivery (aOR 5.75, 95%CI3.701-8.961), maternal delivery BMI < 25 kg/m2 (aOR 2.010, 95%CI1.303-3.286), estimated fetal weight < 3500 g (aOR 2.193, 95%CI1.246-3.860), and gestational age ≤ 39 weeks (aOR 1.501, 95%CI1.038-2.173) significantly increased the probability of successful vaginal delivery following labor induction. The final prediction model has been internally validated. Model calibration and discrimination were satisfactory with Hosmer-Lemeshow test P= 0.21 and with AUC of 0.732 (95% CI 0.692-0.772). Conclusions This study determined the pragmatic predictors for successful vaginal delivery following labor induction comprised of history of previous vaginal delivery, maternal delivery BMI < 25 kg/m2, estimated fetal weight < 3500 g, and gestational age ≤ 39 weeks. The final induction prediction model was well-performing internally validated prediction model to estimate individual probability when undergoing induction of labor. Despite of restricted population, the predicting factors and model could be useful for further prospective study and clinical practice to improve induction outcomes.

scholarly journals 494: The effect of a sonographic estimated fetal weight on the risk of cesarean delivery in macrosomic and small for gestational age infants

2016 ◽  
Vol 214 (1) ◽  
pp. S270
Author(s):  
Nathan S. Fox ◽  
Kathy C. Matthews ◽  
John Williamson ◽  
Simi Gupta ◽  
Jennifer Lam-Rachlin ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Fetal Weight ◽  
Estimated Fetal Weight

Abdominal Circumference Alone versus Estimated Fetal Weight after 24 Weeks to Predict Small or Large for Gestational Age at Birth: A Meta-Analysis

2017 ◽  
Vol 34 (11) ◽  
pp. 1115-1124 ◽  
Author(s):  
José Yordan ◽  
Bradley Holbrook ◽  
Pranita Nirgudkar ◽  
Ellen Mozurkewich ◽  
Nathan Blue
Keyword(s):  
Gestational Age ◽  
Meta Analysis ◽  
Screening Method ◽  
Case Series ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Large For Gestational Age ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Estimated Fetal Weight

Objective We compared the sensitivity and specificity of abdominal circumference (AC) alone versus estimated fetal weight (EFW) to predict small for gestational age (SGA) or large for gestational age (LGA) at birth. Study Design We searched the literature for studies assessing an ultrasonographic AC or EFW after 24 weeks to predict SGA or LGA at birth. Case series or studies including anomalous fetuses or multiple gestations were excluded. We computed the sensitivity, specificity, and positive and negative predictive values of any AC or EFW cutoff analyzed by at least two studies. Results We identified 2,460 studies, of which 40 met inclusion criteria (n = 36,519). Four studies assessed AC alone to predict SGA (n = 5,119), and six assessed AC to predict LGA (n = 6,110). Sixteen assessed EFW to predict SGA (n = 13,825), and 22 evaluated EFW to predict LGA (n = 18,896). To predict SGA, AC and EFW < 10th percentile have similar ability to predict SGA. To predict LGA, AC cutoffs were comparable to all EFW cutoffs, except that AC > 35 cm had better sensitivity. Conclusion After 24 weeks, AC is comparable to EFW to predict both SGA and LGA. In settings where serial EFWs are inaccessible, a simpler screening method with AC alone may suffice.

scholarly journals Relationship between Sonographic Umbilical cord Diameter and Gestational Age in Third Trimester of Pregnancy

2021 ◽  
pp. 20-27
Author(s):  
Sara Essam ALdabouly ◽  
Mohamed Mohsen El Namori ◽  
Mona Khaled Omar ◽  
Essmat Hamdy AboZeid
Keyword(s):  
Pregnant Women ◽  
Umbilical Cord ◽  
Fetal Growth ◽  
Gestational Age ◽  
Umbilical Vein ◽  
Well Being ◽  
Fetal Weight ◽  
University Hospital ◽  
Third Trimester ◽  
Estimated Fetal Weight

Background: Throughout the fourth week of embryonic development the umbilical cord (UC) is formed, which corresponds to the fifth to the twelfth weeks of gestation. Fetuses with intrauterine growth restriction (IUGR) have leaner UCs than fetuses of appropriate gestational age do, and the caliber of the umbilical vein decreases significantly, resulting in a worsening of the Doppler parameters of the umbilical artery in the mother. The goal of this study was to evaluate the significance of sonographic UC diameter in determining gestational age in third trimester in pregnant women. Methods: We conducted a comparative cross-sectional research on 300 pregnant women aged range between (20-35) years, singleton gestation, gestational age (3rd) trimester estimated from antenatal mothers last menstrual period (LMP), viable fetus, presenting to obstetrics and gynecology department at Tanta university hospital. Results: Highly statistically significant positive correlation between UC diameter and gestational age, BPD, FL, AC, AFI, and estimated fetal weight was found. The increase in UC diameter was positively and significantly correlated with the increase in gestational age and estimated fetal weight, indicating that those who have prolonged gestational age and estimated fetal weight are more likely to have wider UC diameter. Conclusions: The UC diameter (UCD) has the potential to be a valuable indicator of fetal growth, well-being, and perinatal outcome. Sonographic measurement of UC diameter could be an efficient method of measuring fetal growth and predicting gestational age (GA), particularly between 28-40 weeks GA. It is possible that abnormal UC diameter can be a strong indicator to identify antenatal mothers at risk for IUFD and poor fetal outcomes.

scholarly journals Повышение эффективности ультразвуковой диагностики в прогнозировании рождения маловесного для гестационного возраста доношенного ребенка

2020 ◽  
pp. 34-47
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Full Term ◽  
Fetal Weight ◽  
Term Newborn ◽  
Estimated Fetal Weight

Цель исследования - оценка возможностей прогнозирования рождения маловесного для гестационного возраста доношенного ребенка по результатам ультразвукового исследования в третьем триместре беременности. Осуществлен ретроспективный анализ результатов обследования 1 151 одноплодной беременности с анатомически здоровым плодом, проведенного в 2015-2017 гг. в сроки 11+1-13+6 нед, 30+0-33+6 нед и 35+0-36+6 нед беременности. Срок беременности устанавливался по копчико-теменному размеру плода в сроки 11+1-13+6 нед беременности. При ультразвуковом исследовании в третьем триместре беременности расчет предполагаемой массы плода проводился по формуле Hadlock с учетом бипариетального размера, окружности головы и живота, длины бедра плода. Основным изучаемым исходом была масса доношенного новорожденного 10-го процентиля. 1 087 (94,44%) беременностей закончились рождением ребен ка массой ≥10-го процентиля: данные случаи были отнесены к группе сравнения. 64 (5,56%) случая с массой доношенного новорожденного 10-го процентиля составили группу исследования (маловесные для гестационного возраста). ROC-анализ установил хорошее качество модели прогнозирования рождения доношенного маловесного для гестационного возраста ребенка на основании показателей предполагаемой массы плода как при исследовании в сроки 30+0-33+6 нед беременности (AUC - 0,830, 95%-й доверительный интервал - 0,760-0,902), так и в сроки 35+0-36+6 нед беременности (AUC - 0,888, 95%-й доверительный интервал - 0,818-0,958). При проведении ультразвукового исследования в 30-34 нед беременности для достижения эффективного прогнозирования рождения доношенного маловесного для гестационного возраста ребенка с выбранной чувствительностью 80% пациенткам с предполагаемой массой плода менее 42-го процентиля может быть предложено повторное исследование в 35+0-36+6 нед беременности. В случае выявления предполагаемой массы плода менее 23-го процентиля при повторном исследовании беременная может быть отнесена к группе высокого риска рождения доношенного маловесного для гестационного возраста ребенка с повышенной вероятностью перинатальных осложнений. Повышение дородового выявления беременных с высоким риском рождения доношенного маловесного для гестационного возраста ребенка может быть достигнуто за счет проведения ультразвукового исследования в более поздние сроки беременности. Ключевые слова: ультразвуковое исследование, предполагаемая масса плода, маловесный для гестационного возраста, доношенный новорожденный, ultrasound, estimated fetal weight, small-for-gestational age, full-term newborn

CORRELATION BETWEEN CEREBROPLACENTAL RATIO AND ADVERSE OUTCOMES IN INTRAUTERINE GROWTH RESTRICTION

2018 ◽  
Vol 8 (3) ◽  
pp. 82-89
Author(s):  
Tran Thao Nguyen Nguyen ◽  
Van Duc Vo ◽  
Ngoc Thanh Cao
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Adverse Outcomes ◽  
Growth Restriction ◽  
Fetal Weight ◽  
Intrauterine Growth ◽  
Cerebroplacental Ratio ◽  
Gestational Age At Delivery ◽  
The Mean ◽  
Estimated Fetal Weight

Objectives: To identify the values of CPR in intrauterine growth restriction and evaluate the correlation between cerebroplacental ratio and adverse outcomes in intrauterine growth restriction. Material and methods: A prospective study was conducted on 74 cases of intrauterine growth restriction with an estimated fetal weight less than 10th percentile, at Departement of Obstetric and Gynecology of Hue University of Medicine and Pharmacy from 05/2016 – 05/2017. CPR was calculated by PIMCA/PIUA.. The adverse outcomes included gestational age at delivery, methods used to delivery, APGAR score below 7 at 1 minutes and 5 minutes, admission at NICU, perinatal deaths, neonatals deaths. Results: The mean of CPR in group of early IUGR and late IUGR were 0.55 ± 0.14, 1.59 ± 0.69, respectively. The mean of CPR in group IUGR with an estimated fetal weight under the 3th percentile was 1.49 ± 0.76, lower than the mean of CPR in group IUGR with an estimated fetal weight from 3th percentile to 10th percentile. With cut – off at 1, CPR < 1 had the higher prevalence in group of early IUGR, in group IUGR with the estimated fetal weight below the 3th percentile, in group IUGR with hypoamniotic or oligohydramnios. The mean of gestational age at delivery of group IUGR with CPR < 1 and CPR >1 were 37.00 ± 3.18, and 38.59 ± 1.76, respectively. The rate of emergency cesarean section deliveries in the CPR < 1 and CPR > 1 group were 68.75% and 39.65%, respectively (p <0.05). Percentage of neonatal with APGAR ≤ 7 at 1 minute in the group with CPR < 1 and CPR > 1 were 56.25% and 22.41%, respectively. Rate of prenatal death was 12.5 in group IUGR with CPR < 1. Conclusion: There was a strong correlation between CPR and adverse outcomes in intrauterine growth restriction. Key words: intrauterine growth restriction, CPR ratio, middle cerebro artery, umbilical artery

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