A RANDOMIZED CONTROLLED TRIAL ON THE CLINICAL-VALUE OF UMBILICAL DOPPLER VELOCIMETRY IN ANTENATAL CARE

Citation
Amwj. Omtzigt et al., A RANDOMIZED CONTROLLED TRIAL ON THE CLINICAL-VALUE OF UMBILICAL DOPPLER VELOCIMETRY IN ANTENATAL CARE, American journal of obstetrics and gynecology, 170(2), 1994, pp. 625-634
Citations number
11
Categorie Soggetti
Obsetric & Gynecology
ISSN journal
00029378
Volume
170
Issue
2
Year of publication
1994
Pages
625 - 634
Database
ISI
SICI code
0002-9378(1994)170:2<625:ARCTOT>2.0.ZU;2-1
Abstract
OBJECTIVE: Our aim was to assess the clinical value of umbilical Doppl er velocimetry with regard to maternal hospitalization policy, obstetr ic management, and perinatal outcome. STUDY DESIGN: We conducted a ran domized controlled trial in a university hospital population. A total of 1598 women participated, of whom 809 were allocated to the Doppler group and 789 to the control group. In the Doppler group umbilical Dop pler studies were performed only when indicated. Abnormal pulsatility index values prompted intensified (clinical) fetal monitoring. In the control group Doppler velocimetry was not available. RESULTS: The use of umbilical Doppler velocimetry did not show any clinical of economic al benefit with regard to maternal admission rate and duration or neon atal admission policy and requirements of ventilatory support. Neither did the use of Doppler have any beneficial effect on obstetric manage ment during labor and the occurrence of fetal distress during labor. I n the control group a higher perinatal mortality rate was observed. In the Doppler group the risk ratio of perinatal mortality of fetuses an d infants weighing greater than or equal to 500 gm was 0.45 (95% confi dence interval 0.21 to 0.94), as compared with the control group. Neon atal mortality was equal in both groups; therefore the reduction in pe rinatal mortality was not the result of a delay in timing of fetal dea th. CONCLUSION: Selective use of umbilical Doppler velocimetry in preg nancies ''at fetal risk'' may be of benefit in antenatal care by a red uction of perinatal mortality and especially late fetal mortality.