Comparison of perinatal outcome in fetuses with reverse or absent enddiastolic flow in the umbilical artery and/or fetal descending aorta

Ertan, A. K.; He, Jingyu; Tanriverdi, H. A.; Hendrik, J.; Limbach, H. G.; Schmidt, W.

doi:10.1515/jpm.2003.043

Cited by 20 publications

(18 citation statements)

References 21 publications

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“…3 Prolonged decelerations most often are associated with the foetal compromise. 4 Elevated basal FHR and variability reduction are additional signs of foetal metabolic acidosis. 5 The NST appears to be an excellent predictor of the healthy foetuses.…”

Section: Introductionmentioning

confidence: 99%

Foetal umbilical artery doppler versus NST as predictors of adverse perinatal outcome in severe preeclampsia and foetal growth restriction

Raj¹,

Bhat

Prajwal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: With the advent of electronic foetal monitoring, a relationship between foetal movement and foetal heart rate was observed and that relationship formed the basis for non-stress test (NST). Doppler USG plays an important role in foetal growth restriction (FGR) pregnancies where hemodynamic rearrangements occur in response to foetal hypoxemia. It is now proved that significant Doppler changes occur with reduction in foetal growth at a time when other foetal well-being tests are still normal. This study was done to find out the comparative usefulness of Doppler and NST in the management of FGR and severe preeclampsia and subsequent correlation with perinatal outcome. Methods: This prospective study was conducted on pregnant women with severe preeclamsia and/or FGR beyond 30 weeks of gestation at AHRR Delhi. 50 pregnancies complicated with severe preeclampsia and/or FGR beyond 30 weeks of gestation were selected. Patients meeting the inclusion criteria were subjected to NST. Umbilical arterial Doppler flow was obtained at weekly or twice weekly interval depending on the severity by pulsed wave color doppler indices were measured during foetal apnea by the same examiner at the free loop site where the clearest waveform signal could be visualized. Of 3 measurements, the mean average of S/D ratio was recorded and followed up with serial Doppler assessment and non-stress test. Data was collected and statistical analysis was carried out. Results: The Doppler showed changes earlier than NST giving a significant lead time of up to 20 days with an average of 4.94 days. The UA S/D had the highest sensitivity (88%) and diagnostic accuracy (94%) in predicting the adverse perinatal outcome. The sensitivity and specificity of Doppler as compared to NST was 82.6% and 63.0% respectively with a diagnostic accuracy of 72%. The Doppler has negative predictive value of 80.95% and positive predictive value of 65.5%. Color Doppler has diagnostic accuracy of 72%. The mortality rate in reversal of diastolic flow was 77.77% and in absent UA flow was 16.66%. 12% foetuses were found to have AEDV in UA and among them 66.66% had both FGR+PE as maternal complication. There was 83.33% rate of LSCS, 16.66% neonatal mortality rate, 83.33% NICU stay rate and 66.66% complication rate in neonates. Whereas 18% had REDV and among that 88.88% had both FGR+PE as maternal complication, a similar rate of LSCS, 77.77% rate of neonatal mortality, 100 % NICU stay and 66.66% complication rate in the neonates. Conclusions: Combined foetal testing modalities such as Doppler, NST and biophysical profile provide a wealth of information regarding foetal health. Integrated foetal testing would be ideal for individualized care of the preterm compromised foetuses for timed intervention.

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Section: Introductionmentioning

confidence: 99%

Foetal umbilical artery doppler versus NST as predictors of adverse perinatal outcome in severe preeclampsia and foetal growth restriction

Raj¹,

Bhat

Prajwal

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…Because most studies pool cases of AED and RED for the purpose of analysis as if they represented a single clinical phenomenon, differences in prognosis remain unclear [8] . However, the elevated rates of morbidity and mortality associated with these conditions make studies on hemodynamic changes urgent in order to determine the most appropriate perinatal management and improve neonatal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Differences in Neonatal Outcome in Fetuses with Absent versus Reverse End-Diastolic Flow in Umbilical Artery Doppler

et al. 2010

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Objectives: It was the aim of this study to evaluate differences in the prognosis of fetuses with absent (AED) and reverse end-diastolic (RED) flow in the umbilical artery based on neonatal outcomes. Methods: We performed a cross-sectional study based on the records of 143 patients attending at Assis Chateaubriand Teaching Maternity between 1 January 1999 and 31 December 2005. Patients were classified according to diagnosis as having either fetal centralization (FC), AED or RED. Obstetrical findings and perinatal outcomes were compared for the 3 groups and between AED and RED by Fisher’s exact test. Perinatal outcomes were analyzed quantitatively with logistic or multinomial regression. Odds ratios were calculated for significant risk factors. Results: There was a statistically significant difference in gestational age at diagnosis, Apgar scores at 1 and 5 min, Capurro score, use of surfactant and mechanical ventilation, admission to the neonatal intensive care unit, perinatal and neonatal death. When comparing RED with AED, the odds of neonatal intensive care unit admission, mechanical ventilation, use of surfactant, neonatal mortality and perinatal mortality were 3.2, 1.4, 1.0, 5.1 and 5.3 times higher for RED. Only perinatal mortality kept statistically significant with odds of 5.2 (p = 0.043) when adjusted by gestational age (multivariate analysis). Conclusion: The incidence of perinatal mortality was observed to increase with the severity of Doppler findings, with significant differences between the AED and RED groups.

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“…Anormal umbilikal arter akımında, gerek ters akım gerekse akım kaybı IUBG olan fetüsü somatik (6,7,17) . Anormal umbilikal akımlı prematürelerin uzun süreli nörogelişimsel izlemi ile ilgili çalışmalar çok kısıtlıdır (5)(6)(7)(8)18,19) . Araştırmaların olgu sayısı, değerlendirme yaşı ve metodu farklı olduğundan sonuçları tartışmalıdır.…”

Section: Discussionunclassified

“…(5) AREDF ve REDF tanımlanan olgularda intrakranial kanama ve yoğun bakım ünitesinde yatış sıklığını benzer oranda rapor etmişlerdir. Çalışmamızda, İKK çalışma grubunda 3 (%7,9) olgu, kontrol grupta 1 (%3,3) prematürede evre I-II İKK düzeyinde saptanırken, anormal umbilikal akımlı Bayley III testi riskli olguların uzun süreli izleminde kullanılan önemli bir ölçektir.…”

Section: Discussionunclassified

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Neurodevelopmental and Somatic Growth Outcomes of Premature IUGR Newborns with Absent or Reversed End-diastolic Flow on Umblical Artery Doppler

Serdaroğlu¹,

Aldemir²,

Kavuncuoğlu³

et al. 2017

IKSST

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Comparison of perinatal outcome in fetuses with reverse or absent enddiastolic flow in the umbilical artery and/or fetal descending aorta

Cited by 20 publications

References 21 publications

Foetal umbilical artery doppler versus NST as predictors of adverse perinatal outcome in severe preeclampsia and foetal growth restriction

Foetal umbilical artery doppler versus NST as predictors of adverse perinatal outcome in severe preeclampsia and foetal growth restriction

Differences in Neonatal Outcome in Fetuses with Absent versus Reverse End-Diastolic Flow in Umbilical Artery Doppler

Neurodevelopmental and Somatic Growth Outcomes of Premature IUGR Newborns with Absent or Reversed End-diastolic Flow on Umblical Artery Doppler

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