FETAL MIDDLE CEREBRAL ARTERY DOPPLER IN LATE-TERM PREGNANCY: A PREDICTING FACTOR FOR FAILED INDUCTION OF LABOR
Mostafa Mahmoud, Yomna Islam
Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University
Objective: To study the role of the pre-induction measurement of fetal MCA Doppler and other variables in prediction of failed induction of labor in late term pregnancy in order to save time, effort, resources and investments, hospitalization, and risks related. Methods: A prospective cohort study on 150 pregnant patients in late term pregnancy who were admitted for induction of labor was conducted. Before induction measurement of MCA PI and set of other ultra-sonographic measurement for other variables that may influence the success of induction of labor e.g.: cervical length and Estimated fetal weight . Induction of labor done by 25 gm of intra vaginal misoprostol /4 hrs, the patient is divided into 2 groups according to response to induction (Responders and non-Responders). Results: Women who fail to enter active phase of labor and failed to deliver vaginally and ended by C-Section showed higher MCA PI and at cut off value > 1.41The MCA PI carried the sensitivity of 94.4% and specificity of 80.0% in predicting the outcome. They also had longer CL, higher EFW and younger in age. Conclusion: Pre-induction measurement of MCA PI, Cervical length, EFW can give a good predictive information about possibility of failure of induction.