Disproportionate intrauterine growth retardation at 36 weeks gestational weeks and on
Conditions
Interventions
Women will be randomly allocated to induction of delivery (intervention group) or expectant monitoring group (expectant group).
Fetal condition will be assessed using fetal heart rate pattern, sonog
Sponsors
None
Eligibility
Inclusion criteria
Inclusion criteria: 1. Women with a presumed diagnosis of growth failure > 36 completed weeks; 2. Women are identified initially by clinical assessment of fetal growth between 35 and 39 weeks. After identification, patients will be referred for fetal biometry, a non-stress test and Doppler ultrasound of the umbilical artery and the a. cerebri media; 3. Patients in whom the diagnosis of growth failure > 36 is confirmed, and in whom the obstetrician is uncertain whether delivery is indicated or not are eligible for the study; 4. The final entry criteria are an accurate ultrasound dating scan before 20 weeks and clinical suspicion of failure to thrive in-utero after 36 completed weeks or later, while the clinician is uncertain whether to induce or to await spontaneous delivery.
Exclusion criteria
Exclusion criteria: 1. Multiple pregnancy; 2. Obstrtical history with caesarean section; 3. Breech; 4. Inacurate dating of gestational age; 5. Suspected congenital malformation; 6. Fetal distress needing delivery.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Under the condition of equal short term neonatal outcome, the primary outcome will be the number of obstetrical interventions. ,strong> Neonatal outcome: - Umbilical cord pH< 7.10 - Base Excess < -10 Apgar 5 min. < 7 - Neonatal admittance to NICU | — |
Secondary
| Measure | Time frame |
|---|---|
| - We will also compare costs. - We aim assessment of the children later in life. Postal enquiries as the CBCL and ASQ will be used | — |
Contacts
Public ContactK. Boers
Leiden University Medical Center (LUMC), Department of Obstetrics, (k6-27), P.O. Box 9600
Outcome results
None listed