Proposal of fetal asphyxia treatment without caesarean delivery

Aim: To reduce caesarean delivery in NRFS cases with intrauterine treatment of fetal asphyxia.

Method: The nonreassurig fetal status (NRFS) case of high placental gray level histogram width (GLHW), which is a tissue characterization, in fetal growth restriction (FGR), the mother is proposed to be treated by heparin infusion, if diagnosed as fibrin depsit in placental intervillous space, under monitoring with ultrasonic Doppler uterine arterial flow, fetal heart rate (FHR) and hemorrhagic tendency etc. a vaginal delivery is selected, if NFRS disappeared, GLHW lowered, estimated fetal weight recovered, and uterine arterial Doppler normalized. The vaginal delivery is carefully monitored in hospital, preparing caesarean delivery in any abnormality.

Results: A 2nd trimester FGR case who had high GLHW was treated byheparin 5000 U infusion every day 17-31 weeks every day.

Author(s): Kazuo Maeda

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