1. Assess differences in flow patterns in the fetal cerebral blood vessels within 24 hours before delivery between fetuses with a normal vs. adverse perinatal outcome. 2. Explore maternal and/or fetal characteristics that might influence technical feasibility of doppler sonography of the fetal cerebral blood vessels in early labor at term. 3. Assess reliability of the technique by measuring intra- and inter-observer variation in a subset of participants.
Singleton pregnancy.
Term gestation (37-42 weeks).
Fetus in cephalic presentation.
No known fetal chromosomal or (severe) congenital anomaly.
Advanced labor (> 4cm of cervical dilatation) at the time of admission on the labor ward.
Severe pre-existing chronic maternal medical condition or poor obstetric history/antenatal complications associated with increased risk of adverse perinatal outcome (non-exhaustive e.g.: uncontrolled chronic hypertension, severe pre-eclampsia, uncontrolled (gestational) diabetes, maternal sepsis, major antepartum haemorrhage, intra-uterine infection, prolonged rupture of membranes > 18 hours, etc.).
Intra-uterine fetal demise / death.
Prelabour rupture of membranes with meconium-stained amniotic fluid.
"Low-risk" pregnant women
Cohort
Prospective
Ultrasound examination in early labor
Other interventionCombined trans-abdominal and trans-perineal ultrasound examination
Differences in VPR (Vertebro-Placental Ratio) between fetuses/neonates with a composite perinatal outcome score < 3 / => 3
Differences in other doppler parameters (PI VA, PI MCA, CPR) between fetuses/neonates with a composite perinatal outcome score < 3 / => 3.
Differences in maternal and fetal characteristics between successful and unsuccessful doppler examinations (observations) of the fetal VA and MCA respectively.
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