What antepartum fetal test should guide the timing of delivery of the preterm growth-restricted fetus? a decision-analysis

Anthony O. Odibo, Joanne N. Quinones, Kirsten Lawrence-Cleary, David M. Stamilio, George A. MacOnes

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

The purpose of this study was to use a decision-analytic approach to explore the best strategy for the timing of the delivery of preterm intrauterine growth-restricted fetuses. We constructed a decision-analysis model that compared 4 antenatal fetal testing strategies The fetal/neonatal states that were compared included live in utero pregnancy; fetal death; neonatal death; disabled neonate, and healthy neonate. Probability estimates for these states and sensitivity and specificity for Doppler velocimetry and biophysical profile were derived from literature review. Sensitivity analyses were performed on the baseline assumptions. Under the baseline assumptions, biophysical profile was the best test to guide decisions on delivery. Sensitivity analyses revealed the model to be sensitive only to the specificity of a biophysical profile <82%. Compared with the other options, biophysical profile was the best strategy to guide physicians on the timing of the delivery of the preterm growth-restricted fetus.

Original languageEnglish
Pages (from-to)1477-1482
Number of pages6
JournalAmerican journal of obstetrics and gynecology
Volume191
Issue number4
DOIs
StatePublished - Oct 1 2004

Keywords

  • Biophysical profile
  • Doppler velocimetry
  • Fetal testing
  • Growth restriction
  • Preterm fetus

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