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Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania

(1) Background: The main challenge in cases of early onset fetal growth restriction is management (i.e., timing of delivery), trying to determine the optimal balance between the opposing risks of stillbirth and prematurity. The aim of this study is to determine the likelihood of neonatal complicatio...

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Autores principales: Bujorescu, Daniela-Loredana, Ratiu, Adrian, Citu, Cosmin, Gorun, Florin, Gorun, Oana Maria, Crisan, Doru Ciprian, Cozlac, Alina-Ramona, Chiorean-Cojocaru, Ioana, Tunescu, Mihaela, Popa, Zoran Laurentiu, Folescu, Roxana, Motoc, Andrei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145500/
https://www.ncbi.nlm.nih.gov/pubmed/37109031
http://dx.doi.org/10.3390/jpm13040645
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author Bujorescu, Daniela-Loredana
Ratiu, Adrian
Citu, Cosmin
Gorun, Florin
Gorun, Oana Maria
Crisan, Doru Ciprian
Cozlac, Alina-Ramona
Chiorean-Cojocaru, Ioana
Tunescu, Mihaela
Popa, Zoran Laurentiu
Folescu, Roxana
Motoc, Andrei
author_facet Bujorescu, Daniela-Loredana
Ratiu, Adrian
Citu, Cosmin
Gorun, Florin
Gorun, Oana Maria
Crisan, Doru Ciprian
Cozlac, Alina-Ramona
Chiorean-Cojocaru, Ioana
Tunescu, Mihaela
Popa, Zoran Laurentiu
Folescu, Roxana
Motoc, Andrei
author_sort Bujorescu, Daniela-Loredana
collection PubMed
description (1) Background: The main challenge in cases of early onset fetal growth restriction is management (i.e., timing of delivery), trying to determine the optimal balance between the opposing risks of stillbirth and prematurity. The aim of this study is to determine the likelihood of neonatal complications depending on the time of birth based on Doppler parameters in fetuses with early onset fetal growth restriction; (2) Methods: A case–control study of 205 consecutive pregnant women diagnosed with early onset FGR was conducted at the Obstetrics Clinic of the Municipal Emergency Hospital in Timisoara, Romania; The case group included newborns who were delivered at the onset of umbilical arteries absent/reversed end-diastolic flow, and the control included infants delivered at the onset of reversed/absent ductus venosus A-wave. (3) Results: The overall neonatal mortality rate was 2.0%, and there was no significant statistical difference between the two study groups. In infants delivered up to 30 gestational weeks, grades III/IV intraventricular hemorrhage and bronchopulmonary dysplasia were statistically significantly more frequent in the control group. Moreover, univariate binomial logistic regression analysis on fetuses born under 30 gestational weeks shows that those included in the control group are 30 times more likely to develop bronchopulmonary dysplasia and 14 times more likely to develop intraventricular hemorrhage grades III/IV; (4) Conclusions: Infants delivered according to the occurrence of umbilical arteries absent/reversed end-diastolic flow are less likely to develop intraventricular hemorrhage grades III/IV and bronchopulmonary dysplasia.
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spelling pubmed-101455002023-04-29 Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania Bujorescu, Daniela-Loredana Ratiu, Adrian Citu, Cosmin Gorun, Florin Gorun, Oana Maria Crisan, Doru Ciprian Cozlac, Alina-Ramona Chiorean-Cojocaru, Ioana Tunescu, Mihaela Popa, Zoran Laurentiu Folescu, Roxana Motoc, Andrei J Pers Med Article (1) Background: The main challenge in cases of early onset fetal growth restriction is management (i.e., timing of delivery), trying to determine the optimal balance between the opposing risks of stillbirth and prematurity. The aim of this study is to determine the likelihood of neonatal complications depending on the time of birth based on Doppler parameters in fetuses with early onset fetal growth restriction; (2) Methods: A case–control study of 205 consecutive pregnant women diagnosed with early onset FGR was conducted at the Obstetrics Clinic of the Municipal Emergency Hospital in Timisoara, Romania; The case group included newborns who were delivered at the onset of umbilical arteries absent/reversed end-diastolic flow, and the control included infants delivered at the onset of reversed/absent ductus venosus A-wave. (3) Results: The overall neonatal mortality rate was 2.0%, and there was no significant statistical difference between the two study groups. In infants delivered up to 30 gestational weeks, grades III/IV intraventricular hemorrhage and bronchopulmonary dysplasia were statistically significantly more frequent in the control group. Moreover, univariate binomial logistic regression analysis on fetuses born under 30 gestational weeks shows that those included in the control group are 30 times more likely to develop bronchopulmonary dysplasia and 14 times more likely to develop intraventricular hemorrhage grades III/IV; (4) Conclusions: Infants delivered according to the occurrence of umbilical arteries absent/reversed end-diastolic flow are less likely to develop intraventricular hemorrhage grades III/IV and bronchopulmonary dysplasia. MDPI 2023-04-08 /pmc/articles/PMC10145500/ /pubmed/37109031 http://dx.doi.org/10.3390/jpm13040645 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bujorescu, Daniela-Loredana
Ratiu, Adrian
Citu, Cosmin
Gorun, Florin
Gorun, Oana Maria
Crisan, Doru Ciprian
Cozlac, Alina-Ramona
Chiorean-Cojocaru, Ioana
Tunescu, Mihaela
Popa, Zoran Laurentiu
Folescu, Roxana
Motoc, Andrei
Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
title Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
title_full Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
title_fullStr Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
title_full_unstemmed Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
title_short Appropriate Delivery Timing in Fetuses with Fetal Growth Restriction to Reduce Neonatal Complications: A Case—Control Study in Romania
title_sort appropriate delivery timing in fetuses with fetal growth restriction to reduce neonatal complications: a case—control study in romania
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10145500/
https://www.ncbi.nlm.nih.gov/pubmed/37109031
http://dx.doi.org/10.3390/jpm13040645
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