Combination of Doppler measurements with amniotic fluid volume for the prediction of perinatal outcomes in fetal growth restriction

Abstract

Objectives:We aimed to evaluate a new ratio of amniotic fluid volume (AFV) to Doppler measurements, and compare its association with adverse perinatal outcomes (APOs) in fetal growth restriction (FGR).Methods: This prospective study included pregnant women with singleton fetal growthrestricted fetuses. Each participant underwent a detailed ultrasonographic examination.Uterine artery pulsatility index, umbilical artery pulsatility index (UA PI), middle cerebral artery pulsatility index (MCA PI), cerebroplacental ratio (CPR), and umbilical-to-cerebral ratio (UCR) were calculated, and the single deepest pocket (SDP) technique was used to estimate AFV. Amniotic-umbilical-to-cerebral ratio (AUCR) was calculated as the ratio of SDP to UCR: AUCR = SDP / (UA PI/MCA PI). APO was defined as umbilical venous cord blood pH <7.10, 5-minute APGAR score <7, and neonatal intensive care unit admission. Results:We compared the fetal ultrasonographic and demographic features between the APO and the non-APO groups. The mean UA PI and UCR were significantly higher in the APO group. The mean SDP, CPR, and AUCR were significantly lower in the APO group. Receiver operating characteristic curve analyses demonstrated the highest area under the curve value (0.882; P < 0.001) for AUCR to APOs. Conclusion:The current study suggests that AUCR is the best predictor for APOs in FGR. K E Y W O R D S adverse perinatal outcomes, amniotic fluid volume, Doppler measurements, fetal growth restriction How to cite this article: Besimoglu B, Uyan Hendem D, Atalay A, et al. Combination of Doppler measurements with amniotic fluid volume for the prediction of perinatal outcomes in fetal growth restriction.

Predictors of adverse perinatal outcomes in fetal growth restriction using a combination of maternal clinical factors and simple ultrasound parameters

“…In our study, some predictors of adverse perinatal outcomes, including chronic hypertension, 13–18 PIH history, 16,17 PIH, 13,14 and early‐onset FGR, 13–15 and all three simple ultrasound parameters (i.e., EFW < 5th percentile, 19 AFI <5 cm, 15 and abnormal UA Doppler 13,14,16,18–21 ) were consistent with those in previous reports. With regard to PIH history, chronic hypertension, and current pregnancy PIH, the results were expected because these factors were associated with maternal vascular diseases, leading to adverse effects on fetal growth and well‐being due to placental insufficiency.…”

“…In our study, some predictors of adverse perinatal outcomes, including chronic hypertension, [13][14][15][16][17][18] PIH history, 16,17 PIH, 13,14 and early-onset FGR, [13][14][15] and all three simple ultrasound parameters (i.e., EFW < 5th percentile, 19 AFI <5 cm, 15 and abnormal UA Doppler 13,14,16,[18][19][20][21] ) were consistent with those in previous reports.…”