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

Publication/Presentation Date

10-1-2004

Abstract

OBJECTIVE: 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.

STUDY DESIGN: 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.

RESULTS: 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%.

CONCLUSION: 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.

Volume

191

Issue

4

First Page

1477

Last Page

1482

ISSN

0002-9378

Disciplines

Medicine and Health Sciences

PubMedID

15507986

Department(s)

Department of Obstetrics and Gynecology

Document Type

Article

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