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Prediction of labour outcomes using prelabour computerised cardiotocogram and maternal-foetal Doppler indices: A prospective cohort study
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  • Sakita Moungmaithong,
  • Michelle Sung Nga Lam,
  • Angel Hoi Wan Kwan,
  • Sani Tsz Kei Wong,
  • Wing Ting TSE,
  • Daljit Sahota,
  • Sin Ting Angela Tai,
  • Liona Poon
Sakita Moungmaithong
Mahidol University Faculty of Medicine Siriraj Hospital

Corresponding Author:sakitamfm@gmail.com

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Michelle Sung Nga Lam
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Angel Hoi Wan Kwan
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Sani Tsz Kei Wong
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Wing Ting TSE
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Daljit Sahota
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Sin Ting Angela Tai
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Liona Poon
The Chinese University of Hong Kong Department of Obstetrics and Gynaecology
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Abstract

Objectives: To investigate the association and the potential value of prelabour fetal heart rate short-term variability (STV) determined by computerised cardiotocography (cCTG) and maternal-foetal Dopplers in predicting labour outcomes. Design: Prospective cohort study. Setting: The Prince of Wales Hospital, a tertiary maternity unit, in Hong Kong SAR. Population: Women with a term singleton pregnancy in latent phase of labour or prior to labour induction were recruited during May 2019 – November 2021. Methods: Ultrasonographic assessment of foetal growth, Doppler velocimetry and the cCTG monitoring including Dawes-Redman CTG analysis. Main Outcome Measures: Umbilical Cord arterial pH, emergency delivery due to pathological CTG during labour and neonatal intensive care unit (NICU)/special care baby unit (SCBU) admission. Results: Of the 400 cases, 34 (8.5%) women underwent emergency delivery for pathological CTG during labour. A total of 6 (1.50%) and 148 (37.00%) newborns required NICU and SCBU admission, respectively. Middle cerebral artery pulsatility index (MCA-PI) and MCA-PI z-score were significant lower in pregnancies that required emergency delivery for pathological CTG during labour compared with those who did not [1.23 (1.07-1.40) vs 1.40 (1.22-1.64), p=0.002 and 0.55 (±1.07) vs 0.12 (±1.06), p=0.049,]. Umbilical cord arterial pH was associated with STV (r = 0.107, p = 0.035) and the independent predictors for umbilical cord arterial pH were smoking (p = 0.006) and STV (p = 0.025). Conclusions: In pregnant women admitted in latent phase of labour or for induction of labour at term, cCTG STV is associated with umbilical cord arterial pH but not predictive of emergency delivery due to pathological CTG during labour.
10 May 2023Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
11 May 2023Submission Checks Completed
11 May 2023Assigned to Editor
11 May 2023Review(s) Completed, Editorial Evaluation Pending
26 May 2023Reviewer(s) Assigned
24 Jun 2023Editorial Decision: Revise Major
02 Aug 20231st Revision Received
05 Aug 2023Submission Checks Completed
05 Aug 2023Assigned to Editor
05 Aug 2023Review(s) Completed, Editorial Evaluation Pending
02 Sep 2023Editorial Decision: Accept