Multifactorial model using color Doppler ultrasound and fetal heart rate monitoring for early prediction of fetal distress

Fetal distress, often resulting from intrauterine hypoxia, has a significant impact on neonatal outcomes but remains difficult to detect accurately using traditional methods. This study introduces a multifactorial model that integrates Doppler ultrasound and fetal heart rate (FHR) monitoring to improve early, non-invasive prediction of fetal distress. To evaluate the predictive value of color Doppler combined with FHR monitoring in diagnosing fetal distress and to develop a multifactorial model for early detection. A case-control study was conducted involving 66 pregnant women with confirmed fetal distress and 107 controls, followed by a cross-sectional validation study with 101 participants. Data were collected on multiple ultrasound parameters (umbilical artery systolic/diastolic ratio [S/D], resistance index [RI], pulsatility index [PI]; middle cerebral artery RI, PI; cerebroplacental ratio) along with FHR monitoring. Logistic regression was performed to establish a model for predicting fetal distress, and the accuracy of the prediction model was validated using cross-validation. The model demonstrated a sensitivity of 92.6 %, a specificity of 86.5 %, and an area under the ROC curve of 0.93. Significant differences were observed in umbilical artery S/D, middle cerebral artery PI, and FHR monitoring values between the study and control groups (p < 0.05). The multifactorial model showed superior diagnostic performance for fetal distress compared with single-parameter assessments. The multifactorial model integrating color Doppler ultrasound and FHR monitoring enhanced the accuracy of fetal distress prediction and shows potential as a reliable clinical reference tool.