Cardiotocography alone versus cardiotocography plus Doppler evaluation of the fetal middle cerebral and umbilical artery for intrapartum fetal monitoring: a Greek prospective controlled trial

Abstract

Objective: The present study was designed to assess the utility of Doppler velocimetry in the setting of non-reassuring cardiotocography tracings. Methods: Two hundred fifty six women with term singleton pregnancies were enrolled in a controlled trial. Patients received either routine cardiotocograpic (CTG) monitoring, or CTG with the addition of Doppler velocimetry in cases of non-reassuring CTG tracings. The results were analyzed according to protocol. Results: In the CTG+Doppler group, there was a trend toward lower risk of neonatal metabolic acidosis than in the CTG group, although the incidence was rare. The CTG+Doppler group had significantly lower rates of cesarean section for fetal distress, and improved neonatal outcomes. Conclusions: We conclude that intrapartum fetal Doppler velocimetry, when combined with CTG, increases the clinicians’ ability to accurately identify fetal hypoxia, and decreases the rate of Cesarean section.

Keywords::

• Doppler ultrasonography
• intrapartum fetal hypoxia
• middle cerebral and umbilical artery
• metabolic acidosis
• cesarean section rate

Declaration of Interest: The Authors declare no conflict of interest.