Evaluation Of Perinatal Outcome By Antenatal CTG And Umbilical Artery Doppler In Preeclampsia – A Randomized Controlled Study.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 11
Abstract
This was a well-controlled hospital-based longitudinal prospective randomized study with a sole focus on preeclampsia cases, where cardiotocography (CTG) and colored Doppler were the two special investigative tools applied for fetal risk assessment. The study concluded with a note that antenatal CTG is a useful objective test to know the intrauterine fetal status but it cannot forecast the fetal behavior during labor, neither does it provide a guide to optimize the timing of induction of labor (IOL) or termination by cesarean section. Color Doppler indices done after 34 weeks definitely give a qualitative assessment of fetoplacental perfusion but it cannot predict the said perfusion during labor - when there occurs a degree of compromise with the uterus contracting repetitively. Ultrasonography (USG) for fetal biometry and liquor volume is a good test to determine small for gestational age or intrauterine growth restriction (IUGR) as the case may be taking cognizance of other factors eg. preeclampsia, fetal congenital anomaly etc. Every mother with preeclampsia needs to be evaluated both clinically, biochemically and ultrasonologically. Understanding the limitation of antenatal CTG and color Doppler indices, these should be applied in a few selected cases e.g. decreased fetal movement, IUGR; which is reassuring to both the patient and the doctor who can wait till a reasonable degree of fetal maturity occurs before one goes for IOL or a cesarean section. Patients with a suspicious CTG should undergo continuous CTG during labor - otherwise there is always a tendency to go for an early lower-segment cesarean section (LSCS). For a preeclamptic mother with a pathological CTG the decision is an emergency LSCS; whereas cases with pathological CTG but normal Doppler indices the judgment is too difficult. The answer then would lie on factors like whether the preeclampsia is controlled and whether the biochemical and hematological parameters are within normal limits. Of course thanks to the presence of a special newborn care unit (SNCU) nearby.
Authors and Affiliations
Dr. Tamal Kumar Mandal, Dr. Barunoday Chakraborty
Keywords
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- EP ID EP415533
- DOI 10.9790/0853-1711065864.
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