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

摘要

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 CTGDoppler group, there was a trend toward lower risk of neonatal metabolic acidosis than in the CTG group, although the incidence was rare. The CTGDoppler 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.