Antenatal predictors of neonatal outcome in fetal growth restriction with absent end-diastolic flow in the umbilical artery

Vergani, Patrizia; Roncaglia, Nadia; Locatelli, Anna; Andreotti, Camilla; Crippa, Isabella; Pezzullo, John C.; Ghidini, Alessandro

doi:10.1016/j.ajog.2005.07.032

Cited by 46 publications

(30 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, studies have shown that umbilical artery Doppler provides significant information when used as a continuous variable, even in the presence of absent or reversed end diastolic flow. 4 Moreover, several series have demonstrated the predictive ability of the ratio between umbilical artery and middle cerebral artery flow, 4,5 a measure that was not assessed in the study of Baschat et al 3 A particularly useful characteristic of Doppler in comparison with biophysical profile or nonstress test is that it provides information on a continuous scale, so that the progressive deterioration of the placental function and of the consequent fetal cardiac function can be monitored sequentially. By dichotomizing the umbilical artery Doppler results, the authors fail to take advantage of the full range of information provided by the arterial Doppler.…”

mentioning

confidence: 98%

Doppler of the Ductus Venosus in Severe Preterm Fetal Growth Restriction

Ghidini

2007

Obstetrics & Gynecology

Self Cite

View full text Add to dashboard Cite

mentioning

confidence: 98%

Doppler of the Ductus Venosus in Severe Preterm Fetal Growth Restriction

Ghidini

2007

Obstetrics & Gynecology

Self Cite

View full text Add to dashboard Cite

“…Currently, end-diastolic velocities in the UA are reported qualitatively as present, absent, or reverse [22,23]. Nevertheless, it is likely that the degree of deterioration with AREDV is variable, but there is no technique to quantify this observation.…”

Section: Discussionmentioning

confidence: 99%

Umbilical Artery Half-Peak Systolic Velocity Deceleration Time in Fetal Growth Restriction

Bustos

González²,

Sepúlveda³

2015

Fetal Diagn Ther

View full text Add to dashboard Cite

Objective: To study the umbilical artery (UA) half-peak systolic velocity deceleration time (hPSV-DT) in pregnancies complicated by fetal growth restriction (FGR). Methods: The study included 266 singleton, high-risk pregnancies with an estimated fetal weight <10th percentile, which were examined between 24 and 40 weeks' gestation and delivered within a week from the last ultrasound evaluation. UA hPSV-DT was measured with Doppler ultrasound in the same wave used to measure the pulsatility index. UA hPSV-DT values were correlated with perinatal outcome. Results: UA hPSV-DT <5th percentile was found in 87 and 98% of fetuses with moderate and severe FGR, respectively. 94% of fetuses with a UA hPSV-DT <90 ms had poor perinatal outcome including perinatal death or prolonged admission to the neonatal intensive care unit. None of the fetuses had a UA hPSV-DT <70 ms. Perinatal death occurred in 39 fetuses; UA hPSV-DT was abnormal in all of them, with 95% of these fetuses having values of ≤120 ms. In the group of fetuses with absent/reverse end-diastolic velocity in the UA, the perinatal mortality rate was 51% for those with a UA hPSV-DT ≤90 ms and only 23% for those having a UA hPSV-DT >90 ms (p < 0.01). Conclusions: UA hPSV-DT seems to be a useful technique in the evaluation of pregnancies at risk for FGR and perinatal death. Additionally, hPSV-DT was shown to be a good predictor of perinatal death, with values of <90 ms corresponding to imminent risk of intrauterine demise and values of <70 ms being likely to be incompatible with intrauterine life.

show abstract

“…Of note, 4 of 40 SGA fetuses with normal UA, but abnormal MCA PI in their study had poor perinatal outcomes. Vergani et al [15] demonstrated that a higher cerebral blood flow redistribution, demonstrated by a higher UA/ MCA PI ratio, is the best prognosticator of neonatal mortality and severe morbidity. They suggested that blood flow redistribution at lower gestational age signified a negative prognostic connotation.…”

Section: Sga Fetuses Caused By Uteroplacental Insufficiencymentioning

confidence: 98%