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Impact of fetal gro...
Impact of fetal growth restriction on pregnancy outcome in women undergoing expectant management for preterm pre-eclampsia
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- Cluver, Catherine (författare)
- Mercy Hospital for Women,University of Melbourne
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- Bergman, Lina, 1982 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology
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- Bergkvist, J. (författare)
- Göteborgs universitet,University of Gothenburg
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- Imberg, Henrik, 1991 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för matematiska vetenskaper,Department of Mathematical Sciences
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- Geerts, L. (författare)
- Universiteit Stellenbosch,Stellenbosch University
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- Hall, D. R. (författare)
- Universiteit Stellenbosch,Stellenbosch University
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- Mol, B. W. (författare)
- University of Aberdeen,Monash University
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- Tong, S. (författare)
- Mercy Hospital for Women,University of Melbourne
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- Walker, Susan (författare)
- University of Melbourne,Mercy Hospital for Women
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: Ultrasound in Obstetrics and Gynecology. - 1469-0705 .- 0960-7692. ; 62:5, s. 660-667
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Objectives: To assess whether coexisting fetal growth restriction (FGR) influences pregnancy latency among women with preterm pre-eclampsia undergoing expectant management. Secondary outcomes assessed were indication for delivery, mode of delivery and rate of serious adverse maternal and perinatal outcomes. Methods: We conducted a secondary analysis of the Pre-eclampsia Intervention (PIE) and the Pre-eclampsia Intervention 2 (PI2) trial data. These randomized controlled trials evaluated whether esomeprazole and metformin could prolong gestation of women diagnosed with pre-eclampsia between 26 and 32 weeks of gestation undergoing expectant management. Delivery indications were deteriorating maternal or fetal status, or reaching 34 weeks' gestation. FGR (defined by Delphi consensus) at the time of pre-eclampsia diagnosis was examined as a predictor of outcome. Only placebo data from PI2 were included, as the trial showed that metformin use was associated with prolonged gestation. All outcome data were collected prospectively from diagnosis of pre-eclampsia to 6 weeks after the expected due date. Results: Of the 202 women included, 92 (45.5%) had FGR at the time of pre-eclampsia diagnosis. Median pregnancy latency was 6.8 days in the FGR group and 15.3 days in the control group (difference 8.5 days; adjusted 0.49-fold change (95% CI, 0.33–0.74); P < 0.001). FGR pregnancies were less likely to reach 34 weeks' gestation (12.0% vs 30.9%; adjusted relative risk (aRR), 0.44 (95% CI, 0.23–0.83)) and more likely to be delivered for suspected fetal compromise (64.1% vs 36.4%; aRR, 1.84 (95% CI, 1.36–2.47)). More women with FGR underwent a prelabor emergency Cesarean section (66.3% vs 43.6%; aRR, 1.56 (95% CI, 1.20–2.03)) and were less likely to have a successful induction of labor (4.3% vs 14.5%; aRR, 0.32 (95% CI, 0.10–1.00)), compared to those without FGR. The rate of maternal complications did not differ significantly between the two groups. FGR was associated with a higher rate of infant death (14.1% vs 4.5%; aRR, 3.26 (95% CI, 1.08–9.81)) and need for intubation and mechanical ventilation (15.2% vs 5.5%; aRR, 2.97 (95% CI, 1.11–7.90)). Conclusion: FGR is commonly present in women with early preterm pre-eclampsia and outcome is poorer. FGR is associated with shorter pregnancy latency, more emergency Cesarean deliveries, fewer successful inductions and increased rates of neonatal morbidity and mortality. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Pediatrik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Pediatrics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- delivery
- fetal growth restriction
- latency
- neonatal morbidity
- pre-eclampsia
- induction
- Cesarean section
- preterm pre-eclampsia
- neonatal mortality
- Cesarean section
- delivery
- fetal growth restriction
- induction
- latency
- neonatal morbidity
- neonatal mortality
- pre-eclampsia
- preterm pre-eclampsia
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- ref (ämneskategori)
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- Av författaren/redakt...
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Cluver, Catherin ...
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Bergman, Lina, 1 ...
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Bergkvist, J.
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Imberg, Henrik, ...
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Geerts, L.
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Hall, D. R.
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Mol, B. W.
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Tong, S.
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Walker, Susan
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Pediatrik
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Reproduktionsmed ...
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Ultrasound in Ob ...
- Av lärosätet
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Chalmers tekniska högskola
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Göteborgs universitet