{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:29:37Z","timestamp":1780730977579,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,10]],"date-time":"2020-07-10T00:00:00Z","timestamp":1594339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Identification of the fetus at risk of intrapartum compromise has many benefits. Impaired maternal cardiovascular function is associated with placental hypoperfusion predisposing to intrapartum fetal distress. The aim of this study was to assess the predictive accuracy of maternal hemodynamics for the risk of operative delivery due to presumed fetal compromise in women undergoing induction of labor (IOL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study, patients were recruited between November 2018 and January 2019. Women undergoing IOL were invited to participate in the study. A non\u2010invasive ultrasonic cardiac output monitor (USCOM\u20101A\u00ae) was used for cardiovascular assessment. The study outcome was operative delivery due to presumed fetal compromise, which included Cesarean or instrumental delivery for abnormal fetal heart monitoring. Regression analysis was used to test the association between cardiovascular markers, as well as the maternal characteristics, and the risk of operative delivery due to presumed fetal compromise. Receiver\u2010operating\u2010characteristics\u2010curve analysis was used to assess the predictive accuracy of the cardiovascular markers for the risk of operative delivery for presumed fetal compromise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 99 women were recruited, however four women were later excluded from the analysis due to semi\u2010elective Cesarean section (<jats:italic>n<\/jats:italic>\u2009=\u20092) and failed IOL (<jats:italic>n<\/jats:italic>\u2009=\u20092). The rate of operative delivery due to presumed fetal compromise was 28.4% (27\/95). Women who delivered without suspected fetal compromise (controls) were more likely to be parous, compared to those who had operative delivery due to fetal compromise (52.9% <jats:italic>vs<\/jats:italic> 18.5%; <jats:italic>P<\/jats:italic>\u2009=\u20090.002). Women who underwent operative delivery due to presumed fetal compromise had a significantly lower cardiac index (median, 2.50 <jats:italic>vs<\/jats:italic> 2.60\u2009L\/min\/m<jats:sup>2<\/jats:sup>; <jats:italic>P<\/jats:italic>\u2009=\u20090.039) and a higher systemic vascular resistance (SVR) (median, 1480 <jats:italic>vs<\/jats:italic> 1325\u2009dynes\u2009\u00d7\u2009s\/cm<jats:sup>5<\/jats:sup><jats:italic>, P<\/jats:italic>\u2009=\u20090.044) compared to controls. The baseline model (being parous only) showed poor predictive accuracy, with an area under the curve of 0.67 (95%\u2009CI, 0.58\u20130.77). The addition of stroke volume index (SVI) &lt;\u200936\u2009mL\/m<jats:sup>2<\/jats:sup>, SVR &gt;\u20097.2\u2009logs or SVR index (SVRI) &gt;\u20097.7\u2009logs improved significantly the predictive accuracy of the baseline model (<jats:italic>P<\/jats:italic>\u2009=\u20090.012, <jats:italic>P<\/jats:italic>\u2009=\u20090.026 and <jats:italic>P<\/jats:italic>\u2009=\u20090.012, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this pilot study, we demonstrated that prelabor maternal cardiovascular assessment in women undergoing IOL could be useful for assessing the risk of intrapartum fetal compromise necessitating operative delivery. The addition of SVI, SVR or SVRI improved significantly the predictive accuracy of the baseline antenatal model. Copyright \u00a9 2019 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.21918","type":"journal-article","created":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T18:10:17Z","timestamp":1573495817000},"page":"233-239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Maternal cardiovascular function and risk of intrapartum fetal compromise in women undergoing induction of labor: pilot study"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0658-138X","authenticated-orcid":false,"given":"E.","family":"Kalafat","sequence":"first","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"},{"name":"Middle East Technical University, Department of Statistics  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Barratt","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Nawaz","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5531-4301","authenticated-orcid":false,"given":"B.","family":"Thilaganathan","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"A.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust University of London  London UK"},{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute, St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,10]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Recent declines in induction of labor by gestational age. 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