Fetal Doppler hemodynamic changes in spontaneous versus prostaglandin E1-induced active labor

Wei Hwa Chen, Hung Cheng Lai, Yu Hsuan Tang, Hang Seng Liu

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background. To assess fetal hemodynamic changes before and during active labor, either spontaneous or prostaglandin E1 (PGE1)-induced labor. Materials and methods. This is a prospective longitudinal study and a cohort of 49 healthy women at 37-41+ weeks gestation without signs of fetal distress was investigated until in labor. One group of 23 healthy women had spontaneous active labor, the second group of 26 women was in active labor induced by an intra-cervical administration of PGE1 for elective induction. Blood flow waveform indices (S/D ratio, RI, PI) were assessed by pulsed Doppler ultrasonography from the umbilical artery (UA) and fetal middle cerebral artery (MCA) before and in labor. Both groups were compared for the waveform indices and perinatal outcome including duration of labor, meconium stain, baby sex, birthweight, UA blood gas measurements at delivery, Apgar's scores, prolonged nursery stay (≥ 5 days), and NICU admission. Results. Demographic data of the two groups were comparable. During spontaneous active labor, the S/D ratio and RI became significantly decreased in the UA (p <0.05) and the three waveform indices were decreased more in the MCA (p <0.01, 0.005, 0.05, respectively) compared with those measured before labor. During PGE1-induced active labor, all the waveform indices were not significantly decreased in either the UA or the MCA. The occurrence of abnormal UA blood gas values was significantly more in the PGE1-induced group than in the spontaneous labor group (23.1% vs. 4.3%; p <0.05). No other adverse perinatal outcomes were observed in either group. Conclusions. Decreasing impedance in both the UA and MCA during spontaneous labor is a physiological fetal adaptation to labor to prevent fetal cerebral hypoxia by maintaining adequate brain blood flow during normal parturition. This fetal adaptation phenomenon was not observed in the group of PGE1-induced labor with the result of a high incidence of abnormal UA blood gas values.

Original languageEnglish
Pages (from-to)599-604
Number of pages6
JournalActa Obstetricia et Gynecologica Scandinavica
Volume78
Issue number7
Publication statusPublished - 1999
Externally publishedYes

Fingerprint

Induced Labor
Umbilical Arteries
Alprostadil
Hemodynamics
Middle Cerebral Artery
Gases
Doppler Pulsed Ultrasonography
Fetal Hypoxia
Physiological Adaptation
Brain Hypoxia
Meconium
Fetal Distress
Apgar Score
Nurseries
Electric Impedance
Longitudinal Studies
Coloring Agents
Demography
Parturition
Prospective Studies

Keywords

  • Active labor
  • Doppler velocimetry
  • Hemodynamic changes
  • Prostaglandin

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Fetal Doppler hemodynamic changes in spontaneous versus prostaglandin E1-induced active labor. / Chen, Wei Hwa; Lai, Hung Cheng; Tang, Yu Hsuan; Liu, Hang Seng.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 78, No. 7, 1999, p. 599-604.

Research output: Contribution to journalArticle

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abstract = "Background. To assess fetal hemodynamic changes before and during active labor, either spontaneous or prostaglandin E1 (PGE1)-induced labor. Materials and methods. This is a prospective longitudinal study and a cohort of 49 healthy women at 37-41+ weeks gestation without signs of fetal distress was investigated until in labor. One group of 23 healthy women had spontaneous active labor, the second group of 26 women was in active labor induced by an intra-cervical administration of PGE1 for elective induction. Blood flow waveform indices (S/D ratio, RI, PI) were assessed by pulsed Doppler ultrasonography from the umbilical artery (UA) and fetal middle cerebral artery (MCA) before and in labor. Both groups were compared for the waveform indices and perinatal outcome including duration of labor, meconium stain, baby sex, birthweight, UA blood gas measurements at delivery, Apgar's scores, prolonged nursery stay (≥ 5 days), and NICU admission. Results. Demographic data of the two groups were comparable. During spontaneous active labor, the S/D ratio and RI became significantly decreased in the UA (p <0.05) and the three waveform indices were decreased more in the MCA (p <0.01, 0.005, 0.05, respectively) compared with those measured before labor. During PGE1-induced active labor, all the waveform indices were not significantly decreased in either the UA or the MCA. The occurrence of abnormal UA blood gas values was significantly more in the PGE1-induced group than in the spontaneous labor group (23.1{\%} vs. 4.3{\%}; p <0.05). No other adverse perinatal outcomes were observed in either group. Conclusions. Decreasing impedance in both the UA and MCA during spontaneous labor is a physiological fetal adaptation to labor to prevent fetal cerebral hypoxia by maintaining adequate brain blood flow during normal parturition. This fetal adaptation phenomenon was not observed in the group of PGE1-induced labor with the result of a high incidence of abnormal UA blood gas values.",
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N2 - Background. To assess fetal hemodynamic changes before and during active labor, either spontaneous or prostaglandin E1 (PGE1)-induced labor. Materials and methods. This is a prospective longitudinal study and a cohort of 49 healthy women at 37-41+ weeks gestation without signs of fetal distress was investigated until in labor. One group of 23 healthy women had spontaneous active labor, the second group of 26 women was in active labor induced by an intra-cervical administration of PGE1 for elective induction. Blood flow waveform indices (S/D ratio, RI, PI) were assessed by pulsed Doppler ultrasonography from the umbilical artery (UA) and fetal middle cerebral artery (MCA) before and in labor. Both groups were compared for the waveform indices and perinatal outcome including duration of labor, meconium stain, baby sex, birthweight, UA blood gas measurements at delivery, Apgar's scores, prolonged nursery stay (≥ 5 days), and NICU admission. Results. Demographic data of the two groups were comparable. During spontaneous active labor, the S/D ratio and RI became significantly decreased in the UA (p <0.05) and the three waveform indices were decreased more in the MCA (p <0.01, 0.005, 0.05, respectively) compared with those measured before labor. During PGE1-induced active labor, all the waveform indices were not significantly decreased in either the UA or the MCA. The occurrence of abnormal UA blood gas values was significantly more in the PGE1-induced group than in the spontaneous labor group (23.1% vs. 4.3%; p <0.05). No other adverse perinatal outcomes were observed in either group. Conclusions. Decreasing impedance in both the UA and MCA during spontaneous labor is a physiological fetal adaptation to labor to prevent fetal cerebral hypoxia by maintaining adequate brain blood flow during normal parturition. This fetal adaptation phenomenon was not observed in the group of PGE1-induced labor with the result of a high incidence of abnormal UA blood gas values.

AB - Background. To assess fetal hemodynamic changes before and during active labor, either spontaneous or prostaglandin E1 (PGE1)-induced labor. Materials and methods. This is a prospective longitudinal study and a cohort of 49 healthy women at 37-41+ weeks gestation without signs of fetal distress was investigated until in labor. One group of 23 healthy women had spontaneous active labor, the second group of 26 women was in active labor induced by an intra-cervical administration of PGE1 for elective induction. Blood flow waveform indices (S/D ratio, RI, PI) were assessed by pulsed Doppler ultrasonography from the umbilical artery (UA) and fetal middle cerebral artery (MCA) before and in labor. Both groups were compared for the waveform indices and perinatal outcome including duration of labor, meconium stain, baby sex, birthweight, UA blood gas measurements at delivery, Apgar's scores, prolonged nursery stay (≥ 5 days), and NICU admission. Results. Demographic data of the two groups were comparable. During spontaneous active labor, the S/D ratio and RI became significantly decreased in the UA (p <0.05) and the three waveform indices were decreased more in the MCA (p <0.01, 0.005, 0.05, respectively) compared with those measured before labor. During PGE1-induced active labor, all the waveform indices were not significantly decreased in either the UA or the MCA. The occurrence of abnormal UA blood gas values was significantly more in the PGE1-induced group than in the spontaneous labor group (23.1% vs. 4.3%; p <0.05). No other adverse perinatal outcomes were observed in either group. Conclusions. Decreasing impedance in both the UA and MCA during spontaneous labor is a physiological fetal adaptation to labor to prevent fetal cerebral hypoxia by maintaining adequate brain blood flow during normal parturition. This fetal adaptation phenomenon was not observed in the group of PGE1-induced labor with the result of a high incidence of abnormal UA blood gas values.

KW - Active labor

KW - Doppler velocimetry

KW - Hemodynamic changes

KW - Prostaglandin

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