Prediction of fetal outcome without intrauterine intervention using a cardiovascular profile score: a systematic review and meta-analysis

Objective: With the help of fetal echocardiography, cardiovascular profile score (CVPS) can be evaluated. However, no general agreement has been recognized on the prediction value of CVPS on fetal adverse outcome. Methods: Literature review has identified up to Nov 2012 in the databases. Meta-analysis was performed in a fixed/random-effect model using Revman 5.1.1 and Meta-disc 1.4. The differences among different cut-offs were measured by STATA 11.0. Results: Result from seven studies reported an outcome in favor of significant lower CVPS in fetus of adverse outcome with std. mean difference of -1.17 (95% CI = -1.78, -0.55). The overall performance of CVPS <= 6 prediction adverse outcome evaluated as area under the summary receiver operating characteristic curves (AUC) was 0.8777. The AUC of CVPS <= 7 was 0.8728 and the AUC of CVPS <= 8 was 0.7207. However, the result indicated the performance of CVPS <= 6 prediction adverse outcome had a statistical significance comparing to other two cut-offs. Conclusion: Analysis has proven the CVPS is a credible index for predicting fetal adverse outcome. And once CVPS decreased at eight, the patient should be observed carefully. With the CVPS dropped at seven, treatment is demanded immediately while some cases suffer irreversible cardiac dysfunction.