Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography

Beattie, R. B.; Jc, Dorman

doi:10.1016/0020-7292(89)90443-8

Cited by 11 publications

(11 citation statements)

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“…[16][17][18] In our cohort the rate of neonatal unit admission was almost 3 times higher in SGA neonates with low CPR MoM compared with those SGA neonates with normal CPR MoM (23% vs 8%). The role of the MCA Doppler in SGA pregnancies at term has been investigated in previous studies.…”

Section: Findings In Term Sga Pregnanciesmentioning

confidence: 78%

The association between fetal Doppler and admission to neonatal unit at term

Khalil

Elsaddig

Khan

et al. 2015

American Journal of Obstetrics and Gynecology

110

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Section: Findings In Term Sga Pregnanciesmentioning

confidence: 78%

The association between fetal Doppler and admission to neonatal unit at term

Khalil

Elsaddig

Khan

et al. 2015

American Journal of Obstetrics and Gynecology

110

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“…In a previous study from our unit, we were able to demonstrate the value of umbilical artery waveforms in a high risk population by way of a randomised clinical trial (Tyrrell et al 1990). However, open studies (Beattie & Dornan 1989; Hanretty et al 1989) did not demonstrate any benefit from this technology in low risk pregnancy. We now report on a further study of Doppler ultrasound in a low risk population using randomised methodology and including a larger number of women than previously reported.…”

mentioning

confidence: 92%

Randomised comparison of routine versus highly selective use of Doppler ultrasound in low risk pregnancies

Mason¹,

Lilford²,

Porter³

et al. 1993

BJOG

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Objective To help answer the question: should Doppler ultrasound of the umbilical circulation be made available to all pregnant women as part of their routine antenatal care? Design A randomised trial. Setting St James's University Hospital, Leeds. Subjects 2025 low risk primigravid women. Main outcome measures Obstetric intervention rates and short term neonatal morbidity. Results The incidence of abnormal Doppler was low (1.7%) with complete absence of end diastolic flow in only 0.3% of cases. No significant differences could be demonstrated between control and study women in any of the outcomes measured. Conclusion This study did not demonstrate any benefit or harm from Doppler ultrasound as a routine screening test for all low risk women, whereas our previous studies have suggested that it is useful in high risk pregnancies. Any marginal returns on extending access to Doppler ultrasound from high risk to all women must be small. Since this test has excellent performance characteristics (sensitivity and specificity) for the prediction of fetal hypoxia and acidosis our results call into question the cost to benefit ratio of all tests designed to predict these outcomes in low risk women.

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“…The present study population included a nested case–control subset of patients from the aforementioned study aged 11–12 years (RB Beattie, Unpublished Thesis, 1988) that had had an in utero UAD PI, randomly selected either above (abnormal) or below (normal) the 90th centile for gestational age at 28 weeks’ gestation as per the pre-defined criteria,8 and alternatively defined as abnormal or normal on the PI centile at 34 and 38 weeks of gestation 9. A power calculation estimated that 100 subjects per group should be tested to detect a mean difference of 7.5 (SD of 15) in the scores for components of the British Ability Score-II (BAS-II) assessments of cognitive function at 28 weeks, with a power of 94% at a significance level of 0.05.…”

Section: Methodsmentioning

confidence: 99%

Fetal umbilical artery Doppler pulsatility index and childhood neurocognitive outcome at 12 years

et al. 2016

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ObjectiveTo determine whether an elevated fetal umbilical artery Doppler (UAD) pulsatility index (PI) at 28 weeks’ gestation, in the absence of fetal growth restriction (FGR) and prematurity, is associated with adverse neurocognitive outcome in children aged 12 years.MethodsProspective cohort study, comparing children with a normal fetal UAD PI (<90th centile) (n=110) and those with an elevated PI (≥90th centile) (n=40). UAD was performed at 28, 32 and 34 weeks gestation. At 12 years of age, all children were assessed under standardised conditions at Queen's University, Belfast, UK to determine cognitive and behavioural outcomes using the British Ability Score-II and Achenbach Child Behavioural Checklist Parent Rated Version under standardised conditions. Regression analysis was performed, controlling for confounders such as gender, socioeconomic status and age at assessment.ResultsThe mean age of follow-up was 12.4 years (±0.5 SD) with 44% of children male (n=63). When UAD was assessed at 28 weeks, the elevated fetal UAD group had lower scores in cognitive assessments of information processing and memory. Parameters included (1) recall of objects immediate verbal (p=0.002), (2) delayed verbal (p=0.008) and (3) recall of objects immediate spatial (p=0.0016). There were no significant differences between the Doppler groups at 32 or 34 weeks' gestation.ConclusionsAn elevated UAD PI at 28 weeks' gestation in the absence of FGR or prematurity is associated with lower scores of declarative memory in children aged 12 years. A potential explanation for this is an element of placental insufficiency in the presence of the appropriately grown fetus, which affects the development of the fetal hippocampus and information processing and memory long-term. These findings, however, had no impact on overall academic ability, mental processing and reasoning or overall behavioural function.

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Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography

Cited by 11 publications

References 0 publications

The association between fetal Doppler and admission to neonatal unit at term

The association between fetal Doppler and admission to neonatal unit at term

Randomised comparison of routine versus highly selective use of Doppler ultrasound in low risk pregnancies

Fetal umbilical artery Doppler pulsatility index and childhood neurocognitive outcome at 12 years

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