Correlation of short-term variation and Doppler parameters with adverse perinatal outcome in small-for-gestational age fetuses at term

Stumpfe, Florian M.; Faschingbauer, Florian; Kehl, Sven; Pretscher, Jutta; Stelzl, Patrick; Mayr, Andreas; Schild, R. L.; Schmid, Matthias; Beckmann, Matthias W.; Schneider, Michael

doi:10.1007/s00404-019-05216-7

Cited by 6 publications

(6 citation statements)

References 26 publications

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“…Our study revealed negative significant correlation between CPRMOM and NICU admission, r=-0.302, P<0.001. Stumpf et al [25] in line with our result they conducted a study to detect the effectiveness of Doppl er in predicting fetal compromise, in FT pregnant women at low risk, the authors found a substantial cor relation between Doppler parameters and the risk of NICU admission. Flatley and Kumar [26] studied, analogously, the ability of CPR Doppler to predict adverse perinatal outcomes at a low-risk cases.…”

Section: Discussionsupporting

confidence: 87%

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Effat

Nabil

2021

International Journal of Medical Arts

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Objective of theStudy: To test the efficacy of the cerebroplacental ratio [CPR] in the prediction of early labor fetal distress and adverse neonatal outcomes in full-term [FT] low risk pregnancy. Patients and Methods: One hundred fifty pregnant women met the inclusion and exclusion criteria were subjected for the estimation of umbilical artery [UA] and middle cerebral artery [MCA] pulsatility indices [PI]]. CPR is calculated by dividing MCAPI by UAPI. All of these measures have been converted to multiple medians [MOMs]. The findings of CPR MOM were Correlated with the following; traces of cardiotocography; cesarean section [CS] for fetal distress; 5 min APGAR scoring; cord PH; and NICU admission. The ROC curve was used to test CPRMOM's predictive performance of adverse perinatal outcomes.Results: Out of 150 patients, 18 [12%] showed abnormal CPR MOM<1. All adverse perinatal outcomes were significantly higher among participants with reduced CPR MOM <1 compared to those with normal one, P value =0.000. There was negative significant correlation between CPRMOM and both of emergency CS, [r=-0.293, P<0.001] and NICU admission [r=-0.302, P<0.001. ROC curve showed that CPRMoM is good negative predictor, in both CS due to fetal distress, and NICU admission at cut off values,≤0.97 and ≤0.84 with sensitivity, 72.7 % and 75.0 %, specificity, 91.4 % and 92.3 % with AUCs, 0.778 and 0.827, P = 0.005, and < 0.001 respectively. Conclusion:Reduced CPRMOM < 1 considers a good predictor for both of CS due to fetal distress and NICU admission; however normal CPR doesn't perfectly rule them out. Reduced CPR MOM is a poor predictor for each of initial non reassuring CTG, APGAR score at 5 min and lower umbilical PH. Nevertheless, normal CPRMOM considers as good predictor for normal fetuses.

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Section: Discussionsupporting

confidence: 87%

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Effat

Nabil

2021

International Journal of Medical Arts

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“…Clinical management followed local protocols and guidelines as described in a recent publication [6]. Induction of labor was performed as a sequential approach [23].…”

Section: Clinical Managementmentioning

confidence: 99%

“…Especially, from 37 weeks of gestation onwards FGR fetuses are at increased risk of being undetected prenatally with the consecutive risk of adverse perinatal outcome [4]. Although sonography is part of the daily obstetrical routine, screening for compromised fetuses at term still remains a major challenge within various collectives of fetuses [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Amniotic-Umbilical-to-Cerebral Ratio – A Novel Ratio Combining Doppler Parameters and Amniotic Fluid Volume to Predict Adverse Perinatal Outcome in SGA Fetuses At Term

et al. 2020

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Purpose Introduction of a novel ratio – the amniotic-umbilical-to-cerebral ratio (AUCR) – to predict adverse perinatal outcome in SGA fetuses at term and comparison of its predictive accuracy with established parameters. Materials and Methods This retrospective cohort study included 165 singleton pregnancies with SGA fetuses (birth weight < 10th percentile) at term. Cases with planned vaginal delivery and documented pulsatility indices (PI) of the umbilical artery (UA), middle cerebral artery (MCA), and single deepest pocket (SDP) were included. CPR was calculated as the ratio between MCA PI and UA PI, UCR as the ratio between UA PI and MCA PI. AUCR was defined as follows: SDP/(UA PI/MCA PI). Adverse perinatal outcomes were defined as operative intervention (OI), OI due to fetal distress, admission to the neonatal intensive care unit (NICU), and composite adverse perinatal outcome (CAPO). Associations between Doppler parameters and these outcomes were estimated using regression analyses. Results OI was statistically significantly associated with UCR, SDP, and AUCR, whereas no association was observed for UA PI, MCA PI, and CPR. Fetuses requiring OI due to fetal distress revealed a significantly higher UA PI and UCR as well as a lower MCA PI, CPR, and AUCR. With regard to NICU admission and CAPO, a significantly higher UA PI and lower CPR were found. Furthermore, a significant association was shown for SDP, UCR, and AUCR. AUCR achieved the best area under the curve for all outcome parameters. Conclusion AUCR leads to an improvement in the prediction of unfavorable outcome in SGA fetuses at term. Furthermore, results of our study show that UCR might be superior to CPR.

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“…1). The Doppler parameters of umbilical artery blood flow are the routine indexes of prenatal ultrasound examination.At present, most of the bad pregnancies are related to the abnormal increase of umbilical artery blood Doppler resistance parameters [14][15][16][17][18] .When obstetricians suspect fetal distress or abnormal fetal movement, they usually pay more attention to the abnormal increase in Doppler resistance of umbilical artery blood flow.If there is no abnormal increase in Doppler resistance of umbilical artery blood flow, we often relax our vigilance and think that the fetus is safe for the time being, and it is recommended that the fetus be reexamined in the near future.During the time waiting for reexamination, the fetus may die in the uterus due to torsion of the umbilical cord, missing the best rescue opportunity.Therefore, when the fetus has abnormal fetal heart monitoring and abnormal fetal movement, and the Doppler parameters of umbilical artery blood flow do not increase abnormally or decrease instead, the possibility of umbilical cord torsion should be considered.It has been reported that the high helix of umbilical cord is related to umbilical cord torsion [19][20][21] . It has been reported that when the umbilical cord is high helical, the umbilical vein blood flow velocity at the umbilical wheel will increase [22,23] or the a-wave reverse of the venous catheter will occur [24] .Therefore, when suspected umbilical cord torsion, we also need to pay attention to the contents of unconventional ultrasound examination, such as umbilical cord helix, umbilical vein flow velocity and venous catheter spectrum and so on.…”

Section: Discussionmentioning

confidence: 99%

Correlation between umbilical cord torsion and Doppler parameters of umbilical artery: a single-center retrospective case-control study

Li,

Zhang,

Shi

2023

Preprint

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ObjectiveTo explore the correlation between umbilical cord torsion and the changes of umbilical artery Doppler parameters, to provide valuable information for prenatal ultrasound screening of umbilical cord torsion, and to explore the possible mechanism of umbilical artery Doppler parameters changes during umbilical cord torsion. Method:The subjects were 962 pregnant women who were discharged from our hospital from January 2015 to November 2021 and were eligible for inclusion (415 in the case group and 547 in the control group). The measurement data of umbilical artery Doppler parameters (PSV, S/D, RI, PI) were collected from 21 to 40 weeks of gestation, and the differences among the above parameters were statistically analyzed.ResultsThe peak systolic velocity (PSV) of umbilical artery is positively correlated with gestational age, while the Doppler resistance parameters (S/D, RI, PI) of umbilical artery are negatively correlated with gestational age. The mean values of umbilical artery Doppler parameters (PSV, S/D, RI, PI) in the case group were significantly lower than those in the control group of the same pregnancy age (P < 0.05).ConclusionThe decrease of Doppler parameters of umbilical artery in late pregnancy is significantly related to umbilical cord torsion, which may be a clue for prenatal ultrasound screening of umbilical cord torsion. The Doppler parameters of umbilical artery during umbilical cord torsion are consistent with the basic principle of Doppler parameters change after vascular stenosis in other parts of the human body. It is necessary to conduct multicenter prospective study in the future.

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Correlation of short-term variation and Doppler parameters with adverse perinatal outcome in small-for-gestational age fetuses at term

Cited by 6 publications

References 26 publications

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Effectiveness of Cerebroplacental Ratio Estimation Early in Labor as A predictor of Adverse Perinatal Outcomes in Full-term Low-risk Pregnancy

Amniotic-Umbilical-to-Cerebral Ratio – A Novel Ratio Combining Doppler Parameters and Amniotic Fluid Volume to Predict Adverse Perinatal Outcome in SGA Fetuses At Term

Correlation between umbilical cord torsion and Doppler parameters of umbilical artery: a single-center retrospective case-control study

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