POSTTERM PREGNANCIES WITH NORMAL CARDIOTOCOGRAPHS AND AMNIOTIC-FLUID COLUMNS - THE ROLE OF DOPPLER EVALUATION IN PREDICTING PERINATAL OUTCOME

Objective. To study the role of Doppler ultrasound examination in predicting an abnormal perinatal outcome, among post-term pregnancies uncomplicated by an abnormal non-stress test (NST) or reduced amount of amniotic fluid. Design. A prospective study. Setting. High-risk pregnancy unit, Hadassah Mt. Scopus University Hospital, Jerusalem. Subjects. Seventy-eight women with confirmed gestational age of >287 days, who had normal initial evaluation and unfavourable cervical examination. Interventions. Doppler flow velocity waveforms were recorded from the umbilical and middle cerebral arteries, and from the descending thoracic aorta. Main outcome measures. Correlation between Doppler measurements and data regarding delivery. Results. Women who developed signs of fetal distress during labour, or who required intervention because of fetal distress, had elevated umbilical artery systolic/diastolic ratio, decreased middle cerebral artery pulsatility index, and decreased time average aortic blood flow velocity. Umbilical artery Doppler measurements could significantly predict the need for intervention due to fetal distress. Conclusions. Doppler examination of uncomplicated post-term pregnancies may identify patients with normal results as having a low risk of developing fetal distress during labour. Patients with abnormal Doppler results are prone to need intervention following fetal distress in labour.