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자료유형
학술저널
저자정보
저널정보
대한산부인과학회 Obstetrics & Gynecology Science Obstetrics & Gynecology Science 제61권 제2호
발행연도
2018.1
수록면
202 - 208 (7page)

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ObjectiveTo evaluate the significance of fetal Doppler parameters in predicting adverse neonatal outcomes and the risk ofcesarean delivery due to non-reassuring fetal status, in severe small for gestational age (SGA) fetuses of late pretermand term gestation. MethodsFetal brain and umbilical artery (UmA) Doppler parameters of cerebroplacental ratio (CPR) and UmA pulsatility index(PI) were evaluated in a cohort of 184 SGA fetuses between 34 and 41 weeks gestational age, who were less thanthe 5th percentile. The risks of neonatal morbidities and cesarean delivery due to non-reassuring fetal status wereanalyzed. ResultsUnivariate analysis revealed that abnormal CPR was significantly associated with cesarean delivery due to nonreassuringfetal status (P=0.018), but not with neonatal morbidities. However, abnormal CPR did not increase the riskof cesarean delivery due to non-reassuring fetal status in multivariate logistic regression analysis. Abnormal CPR withabnormal PI of UmA was associated with low Apgar score at 1 minute (P=0.048), mechanical ventilation (P=0.013)and cesarean delivery due to non-reassuring fetal status (P<0.001), in univariate analysis. It increased risk of cesareandelivery for non-reassuring fetal status (adjusted odds ratio, 7.0; 95% confidence interval, 1.2–41.3; P=0.033), but didnot increase risk of low Apgar score or mechanical ventilation in multivariate logistic regression analysis. ConclusionAbnormal CPR with abnormal PI of UmA increases the risk of cesarean delivery for non-reassuring fetal status,in severe SGA fetuses of late preterm and term. Monitoring of CPR and PI of UmA can help guide managementincluding maternal hospitalization and fetal monitoring.

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