An evaluation of the efficacy of Doppler flow velocity waveform analysis as a screening test in pregnancy

Newnham, John P.; Patterson, L; James, Ian; Diepeveen, Dean; Reid, Sharon J.

doi:10.1016/0002-9378(90)90396-o

Cited by 108 publications

(61 citation statements)

References 13 publications

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“…Furthermore, several screening studies at 18-24 weeks gestation have suggested that abnormal Doppler re sults may precede these pregnancy complica tions by several weeks [1][2][3][4][5][6]. The commonly cited pathophysiologic basis for this observa tion is the histologic demonstration of im paired trophoblastic invasion of the mater nal spiral arteries [7][8][9], Since the onset of trophoblastic migration into the spiral arteries normally starts in the first trimester [10,11], it is hypothesized that establishment of the uteroplacental cir culation in the second trimester is not a ran dom phenomenon, but rather a consequence of events in the first trimester.…”

Section: Introductionmentioning

confidence: 99%

Doppler Study of Uterine Artery Blood Flow: Comparison of Findings in the First and Second Trimesters of Pregnancy

Kaminopetros

Higueras

Nicolaides³

1991

Fetal Diagn Ther

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In 55 women with singleton pregnancies, colour flow mapping and pulsed wave velocimetry were used to measure impedance to flow in the uterine arteries at 10–13 weeks gestation and again at 19–22 weeks. In the first trimester, examinations were performed both transabdominally and transvaginally and in the second trimester transabdominally only. There were significant associations between the first- and second-trimester measurements obtained with both Doppler techniques. These associations were higher when transvaginal than transabdominal Doppler was used and when the measurement of impedance was the pulsatility index (PI) rather than the resistance index. These data suggest that impedance to flow in the uteroplacental circulation in the second trimester is dependent on impedance in the first trimester. In any prospective, first-trimester, uterine artery Doppler screening study for pregnancy complications, it may be preferable to use transvaginal Doppler and measure PI.

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Section: Introductionmentioning

confidence: 99%

Doppler Study of Uterine Artery Blood Flow: Comparison of Findings in the First and Second Trimesters of Pregnancy

Kaminopetros

Higueras

Nicolaides³

1991

Fetal Diagn Ther

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“…6,7 Despite these statistically significant correlations, the clinical utility of umbilical artery Doppler studies has been questioned because of its low predictive values for either preeclampsia or FGR and other adverse outcome in low risk population. 8,9 In the present study, we determined whether umbilical artery Doppler velocimetry can predict perinatal outcomes in high risk pregnancies between 28 and 42 gestational weeks.…”

Section: Introductionmentioning

confidence: 99%

Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy

Bhattacharjee

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy. The aim of this study was to study the umbilical artery Doppler velocimetry in predicting the fetal outcome in high risk pregnancy. This is a prospective study done over a period of 1 year in Silchar Medical College and Hospital from 1st September 2011 to 31st August 2012. 100 women with singleton pregnancy with high risk admitted in SMCH were subjected to umbilical artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria.Methods: 100 women with high risk pregnancy were evaluated by umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n = 79; 79%), the low-end diastolic flow group (n = 19; 19%) and the group with absent/reversed diastolic flow (n = 2; 2%).Results: Mothers with abnormal velocimetry had more number of caesarean sections than those with normal velocimetry. The diagnosis to delivery interval, gestational age at delivery and average birth weight were comparatively lower with higher incidence of admission to neonatal intensive care unit in foetuses with abnormal umbilical Doppler velocimetry. Sensitivity, specificity, positive and negative predictive values of Doppler for detecting abnormal fetal outcome were 43%, 83%, 33% and 88% respectively. Statistical analysis used: sensitivity, specificity and predictive values.Conclusions: Fetuses with normal flow velocimetry are at lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower than that of neonates with normal velocimetry. Doppler velocimetry studies of umbilical artery can provide the obstetrician important information regarding fetal wellbeing to help him improve fetal outcome.

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“…15 Estudos correlacionando tais parâmetros entre si demonstraram índice de correlação de 0,98 parece correlacionar com mortalidade perinatal, prematuridade, crescimento intra-uterino retardado e hipóxia fetal. 8,12,14,16 Dados experimentais têm sugerido que nos casos de crescimento intra-uterino retardado (CIUR) ocorrem mudanças na resistência vascular placentária, o que determinaria diminuição do fluxo sanguíneo na artéria umbilical.5 O estudo dopplerfluxométrico da artéria umbilical em tais casos é de um padrão de alta resistência ao fluxo sanguíneo traduzido por diminuição progressiva do componente diastólico, isto é, aumento da relação A/B, seguido por padrões mais graves, como ausência do componente cliast61ico final ou inversão do mesmo. 4,5,17,25 A sensibilidade da dopplerfluxomettia em detectar o CIUR varia de 60 a 75% 5 , sendo que as suas alterações precedem as modificações biométricas fetais, servindo portanto como informrmante rastreador dos casos de crescimento fetal anormal.…”

Section: Introductionunclassified

Uma Experiência Em Orientaçao Sexual Para Adolescentes Na Graduaçao Em Psicologia

Sessa¹,

Pugliese²,

Coltro³

et al. 1991

J. Hum. Growth Dev.

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Através de curso de orientação sexual para adolescentes, extra-curricular, em faculdade privada, os autores descrevem uma experiência de condução de um grupo de adolescentes de 13 a 17 anos do sexo masculino, de escola pública, efetuada em oito encontros semanais de duas horas cada, onde foram trabalhados os aspectos cognitivos referentes aos seguintes temas: anátomo-fisiologia sexual masculina e feminina; jogos amorosos; masturbação; erotismo e pornografia; métodos contraceptivos; gravidez, parto e aborto; doenças sexualmente transmissíveis; desvios sexuais. Os aspectos atitudinais (emocionais/ afetivos) foram trabalhados através de dinamicasde grupo com os adolescentes. Os autores referem a validade da experiência enquanto profissionais da área de Psicologia, percebendo que os pais aceitam e preferem tais abordagens como forma de se cxiniircm de tal responsabilidade.Observam, os autores, que Q momento específico do adolescente deve ser considerado para a orientação sexual. O grupo de orientandos mostrou-se permeado de mitificações sexuais e muito carente de informações cogrutivas sobre sexo, sendo esta, talvez, a razão pela qual buscaram o grupode orientação sexual.

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An evaluation of the efficacy of Doppler flow velocity waveform analysis as a screening test in pregnancy

Cited by 108 publications

References 13 publications

Doppler Study of Uterine Artery Blood Flow: Comparison of Findings in the First and Second Trimesters of Pregnancy

Doppler Study of Uterine Artery Blood Flow: Comparison of Findings in the First and Second Trimesters of Pregnancy

Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy

Uma Experiência Em Orientaçao Sexual Para Adolescentes Na Graduaçao Em Psicologia

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