Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis
Abstract Objective Systematically review and critically appraise the literature on the association between peripartum fetal Doppler sonography findings, i.e., acquired upon admission for spontaneous or induced labor, and perinatal outcome in term (37-42w) pregnancies. Methods Medline, Embase, Web of...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-025-07586-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849311897263800320 |
|---|---|
| author | Bram Packet Ann-Sophie Page Jan Bosteels Jute Richter |
| author_facet | Bram Packet Ann-Sophie Page Jan Bosteels Jute Richter |
| author_sort | Bram Packet |
| collection | DOAJ |
| description | Abstract Objective Systematically review and critically appraise the literature on the association between peripartum fetal Doppler sonography findings, i.e., acquired upon admission for spontaneous or induced labor, and perinatal outcome in term (37-42w) pregnancies. Methods Medline, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov databases were systematically searched from inception to 05/2024. Studies conducted in unselected populations of term (37-42w) pregnancies, admitted for spontaneous or induced labor, reporting the association between fetal Doppler findings and perinatal outcome, were eligible for inclusion. Study eligibility was assessed independently by two reviewers. Methodological quality was assessed using the Quality In Prognosis Studies (QUIPS)-tool. Effect estimates were pooled using random-effects meta-analyses. Summary Odds Ratios (ORs) and Mean Differences (MDs) are reported with 95% confidence intervals. Results Thirty-seven studies, reporting on 11.505 women and neonates, were included. Fourteen studies reported on findings from the umbilical artery (UA), four on the middle cerebral artery (MCA), five on the umbilical vein (UV), and nine on the cerebroplacental ratio (CPR). An abnormal UA Doppler and CPR increased the odds of fetal distress (FD) during labor (UA: OR 3.67 [1.14, 11.78], I2 = 72% – CPR: OR 3.19 [2.68, 3.80], I2 = 0%) and subsequent operative delivery (ODFD) (UA: OR 3.65 [1.66, 8.04], I2 = 81% – CPR: OR 2.48 [1.66, 3.70], I2 = 57%). Likewise, the presence of UV pulsations was strongly associated with both outcomes (FD: OR 28.78 [11.21, 73.87], I2 = 0% – ODFD: OR 303.36 [11.11, 8279.82], I2 = 0%). Regarding neonatal outcome, an Apgar-score < 7 at 5 min and NICU admission occurred more frequently if Doppler findings were abnormal in the UA (Apgar: OR 3.65 [1.82, 7.34], I2 = 0% – NICU: OR 3.92 [2.36, 6.51], I2 = 0%), or in case of an abnormal CPR (Apgar: OR 3.64 [2.03, 6.54], I2 = 0% – NICU: OR 2.71 [1.15, 6.38], I2 = 0%). Neonatal birthweight was also lower in the presence of an abnormal UA or CPR result, with a MD of -630.61g ([-1234.29, -26.93], I2 = 80%) and -146.52g ([-285.03, -8.01], I2 = 0%) respectively. Most studies (70.3%) were at high risk of bias on one or more domains; only 11 studies had an overall low risk of bias score. Conclusion Doppler sonography in the peripartum period allows for the identification of fetuses at risk of adverse birth outcomes. Further research on optimal thresholds to define at-risk cases and subsequent management strategies is needed. PROSPERO registration number CRD42023413264. |
| format | Article |
| id | doaj-art-94ed7c6bb3f644049c2bf2bec7e9fd29 |
| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-94ed7c6bb3f644049c2bf2bec7e9fd292025-08-20T03:53:16ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-0125111710.1186/s12884-025-07586-0Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysisBram Packet0Ann-Sophie Page1Jan Bosteels2Jute Richter3Department of Development and Regeneration, Unit of Woman and Child, Catholic University of Leuven (KU Leuven)Department of Development and Regeneration, Unit of Urogenital, Abdominal and Plastic Surgery, Catholic University of Leuven (KU Leuven)Department of Development and Regeneration, Unit of Urogenital, Abdominal and Plastic Surgery, Catholic University of Leuven (KU Leuven)Department of Development and Regeneration, Unit of Woman and Child, Catholic University of Leuven (KU Leuven)Abstract Objective Systematically review and critically appraise the literature on the association between peripartum fetal Doppler sonography findings, i.e., acquired upon admission for spontaneous or induced labor, and perinatal outcome in term (37-42w) pregnancies. Methods Medline, Embase, Web of Science, Cochrane Library, and clinicaltrials.gov databases were systematically searched from inception to 05/2024. Studies conducted in unselected populations of term (37-42w) pregnancies, admitted for spontaneous or induced labor, reporting the association between fetal Doppler findings and perinatal outcome, were eligible for inclusion. Study eligibility was assessed independently by two reviewers. Methodological quality was assessed using the Quality In Prognosis Studies (QUIPS)-tool. Effect estimates were pooled using random-effects meta-analyses. Summary Odds Ratios (ORs) and Mean Differences (MDs) are reported with 95% confidence intervals. Results Thirty-seven studies, reporting on 11.505 women and neonates, were included. Fourteen studies reported on findings from the umbilical artery (UA), four on the middle cerebral artery (MCA), five on the umbilical vein (UV), and nine on the cerebroplacental ratio (CPR). An abnormal UA Doppler and CPR increased the odds of fetal distress (FD) during labor (UA: OR 3.67 [1.14, 11.78], I2 = 72% – CPR: OR 3.19 [2.68, 3.80], I2 = 0%) and subsequent operative delivery (ODFD) (UA: OR 3.65 [1.66, 8.04], I2 = 81% – CPR: OR 2.48 [1.66, 3.70], I2 = 57%). Likewise, the presence of UV pulsations was strongly associated with both outcomes (FD: OR 28.78 [11.21, 73.87], I2 = 0% – ODFD: OR 303.36 [11.11, 8279.82], I2 = 0%). Regarding neonatal outcome, an Apgar-score < 7 at 5 min and NICU admission occurred more frequently if Doppler findings were abnormal in the UA (Apgar: OR 3.65 [1.82, 7.34], I2 = 0% – NICU: OR 3.92 [2.36, 6.51], I2 = 0%), or in case of an abnormal CPR (Apgar: OR 3.64 [2.03, 6.54], I2 = 0% – NICU: OR 2.71 [1.15, 6.38], I2 = 0%). Neonatal birthweight was also lower in the presence of an abnormal UA or CPR result, with a MD of -630.61g ([-1234.29, -26.93], I2 = 80%) and -146.52g ([-285.03, -8.01], I2 = 0%) respectively. Most studies (70.3%) were at high risk of bias on one or more domains; only 11 studies had an overall low risk of bias score. Conclusion Doppler sonography in the peripartum period allows for the identification of fetuses at risk of adverse birth outcomes. Further research on optimal thresholds to define at-risk cases and subsequent management strategies is needed. PROSPERO registration number CRD42023413264.https://doi.org/10.1186/s12884-025-07586-0Doppler ultrasonographyParturitionApgar scoreDelivery, obstetricUmbilical arteriesUmbilical veins |
| spellingShingle | Bram Packet Ann-Sophie Page Jan Bosteels Jute Richter Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis BMC Pregnancy and Childbirth Doppler ultrasonography Parturition Apgar score Delivery, obstetric Umbilical arteries Umbilical veins |
| title | Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis |
| title_full | Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis |
| title_fullStr | Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis |
| title_full_unstemmed | Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis |
| title_short | Peripartum fetal Doppler sonography and perinatal outcome: a systematic review and meta-analysis |
| title_sort | peripartum fetal doppler sonography and perinatal outcome a systematic review and meta analysis |
| topic | Doppler ultrasonography Parturition Apgar score Delivery, obstetric Umbilical arteries Umbilical veins |
| url | https://doi.org/10.1186/s12884-025-07586-0 |
| work_keys_str_mv | AT brampacket peripartumfetaldopplersonographyandperinataloutcomeasystematicreviewandmetaanalysis AT annsophiepage peripartumfetaldopplersonographyandperinataloutcomeasystematicreviewandmetaanalysis AT janbosteels peripartumfetaldopplersonographyandperinataloutcomeasystematicreviewandmetaanalysis AT juterichter peripartumfetaldopplersonographyandperinataloutcomeasystematicreviewandmetaanalysis |