RANDOMIZED CONTROLLED TRIAL OF CARDIOTOCOGRAPHY VERSUS UMBILICAL ARTERY DOPPLER IN THE MANAGEMENT OF SMALL-FOR-GESTATIONAL-AGE FETUSES

Objective To compare the impact on use of resources in the management of small for gestational age babies using Doppler ultrasound versus ca rdiotocography. Design A randomised controlled trial. Setting A large district general hospital delivering 5500 to 6000 infants each year, 3 0% to 35% of which are to women of Pakistani origin. Population One hu ndred and fifty women delivered of small for gestational age infants. Main outcome measures Primary outcome measures were length of hospital inpatient stay and induction of labour rates. Secondary outcome measu res included caesarean section rates and length of stay on neonatal un it. Results The use of Doppler reduced average hospital inpatient stay from 2.5 days to 1.1 days, compared with cardiotocography (P=0.036). There was no effect on induction of labour rates or caesarean section rates. There was no significant difference in length of stay on the ne onatal unit (P=0.33). There was a reduction in monitoring frequency an d fewer hospital antenatal clinic visits. Conclusion The use of Dopple r ultrasound to manage small for gestational age infants reduces the u se of resources, compared with cardiotocography.