Cardiovascular profile score as a predictor of acute intrapartum non-reassuring fetal status in infants with congenital heart defects

Abstract

Objectives: To investigate the predictive factors of urgent cesarean delivery (CD) due to acute intrapartum non-reassuring fetal status (NRFS) in infants with congenital heart defects (CHDs).

Study design: This was a retrospective review of 199 singletons prenatally diagnosed with a CHD and for whom vaginal delivery was attempted in our institution between 2007 and 2014. A cardiovascular profile (CVP) score was used to assess fetal heart failure.

Results: The number of urgent CDs due to NRFS was 37 (18.6%). Fetuses with a CVP score ≤7 were significantly more likely to require urgent CD due to NRFS than those with a CVP score ≥8 (p < 0.001). Infants with right heart defects or biventricular cyanotic heart defects had a significantly higher frequency of urgent CD due to NRFS than those with other types of CHD (p = 0.017). Multivariate analysis showed that a CVP score ≤7, a birth weight <2500 g, and primipara status were significant predictors of urgent CD due to NRFS.

Conclusions: Fetal heart failure, low birth weight, and primipara status were revealed to be independent predictors of urgent CD due to acute intrapartum NRFS in CHD infants. The CVP score may be a useful echocardiographic marker in perinatal management planning.

Keywords:

• Cardiovascular profile score
• congenital heart defect
• echocardiography
• fetal heart failure
• non-reassuring fetal status
• prenatal diagnosis

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported in part by a KAKENHI Grant (15K19666) from the Japanese Ministry of Education, Culture, Sports, Science and Technology, and in part by the Intramural Research Fund (26-6-1) of the National Cerebral and Cardiovascular Center of Japan.