Doppler studies in the growth retarded fetus and prediction of neonatal necrotising enterocolitis, haemorrhage, and neonatal morbidity.

Hackett, Gerald; Campbell, Stuart; Gamsu, H R; Cohen–Overbeek, Titia E.; Pearce, J. M.

doi:10.1136/bmj.294.6563.13

Cited by 255 publications

(128 citation statements)

References 18 publications

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“…15,17,[21][22][23] Torres et al in their retrospective study, reported that absence of end diastolic flow was correlated with IUGR in 100% of pregnancies and fetal death by 66.6%. 24 Higher mortality rates are reported in those fetuses with absent or reversed end-diastolic flow on antenatal doppler velocimetry which is similar with present result. 25,26 In this study it was found that still birth and IUD (Intrauterine death) was 4(8%) and neonatal death was 3(6%).…”

Section: Resultsupporting

confidence: 82%

Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses

Afroze¹,

Begum

2016

J. Bangladesh Coll. Phys.

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Objectives: To study pregnancy outcomes in growth restricted fetuses with normal umbilical artery velocimetry, low end-diastolic umbilical flow, and absent or reversed diastolic flow. Methods: Fifty pregnant women with growth restricted fetuses were evaluated by umbilical artery velocimetry between 28 and 39 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n=17; 34%), the low end diastolic flow group (n=23; 46%), the group with absent diastolic flow (n=8; 16%) and the group with reversed diastolic flow (n=2; 4%). Results: The average birth weight, diagnosis to delivery interval and gestational age at delivery were comparatively lower in case of abnormal umbilical Doppler velocimetry group. Again there was higher incidence of LSCS for fetal distress, Apgar score <7 at 1 minute, admission to neonatal intensive care unit and perinatal death with those of the abnormal umbilical Doppler velocimetry. Conclusion: Doppler study of umbilical artery allows a noninvasive assessment of uteroplacental insufficiency and is an accurate method for diagnosis and management of fetal growth retardation.

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Section: Resultsupporting

confidence: 82%

Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses

Afroze¹,

Begum

2016

J. Bangladesh Coll. Phys.

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“…Fetal hypoxia and growth restriction are often the result of adverse intrauterine circumstances, which may initiate the ‘diving reflex', whereby cardiac output is shunted away from the intestines in favor of the brain and heart. This process in combination with reperfusion may result in hypoxic-ischemic injury to the intestines, which contributes to the onset of NEC [9,23]. In addition, immaturity of the gastrointestinal tract is likely to be a contributing factor to the development of NEC, as all our NEC cases were born preterm.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Enterocolitis in Small-for-Gestational-Age Neonates: A Matched Case-Control Study

Ree¹,

Smits-Wintjens²,

Rijntjes-Jacobs³

et al. 2013

Neonatology

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Background: Small for gestational age (SGA) neonates are at increased risk of mortality and morbidity, including necrotizing enterocolitis (NEC), but detailed information on the incidence and risk factors of NEC in SGA neonates is lacking. Objective: This study aims to estimate the incidence of NEC in a large cohort of SGA neonates, compared to appropriate for gestational age (AGA) neonates. Methods: We included all SGA neonates without congenital malformations admitted to our neonatal nursery between 2004 and 2013. Neonates in the SGA group were matched for gestational age with a control group of AGA neonates admitted during the same study period. We recorded the occurrence of NEC and studied the association with SGA and other potential risk factors. Results: A total of 475 SGA neonates were matched for gestational age at birth to 475 control AGA neonates. The incidence of NEC in the SGA group was 3.2% (15/475) versus 1.3% (6/475) in the AGA group (OR 2.55, 95% CI 0.98-6.63, p = 0.047). The incidence of NEC in the subgroups with mild, moderate and severe SGA was 2.3% (5/215), 4.7% (5/1.07) and 3.2% (5/153), respectively (p = 0.531). Conclusions: The risk of development of NEC is more than twofold increased in SGA neonates compared to AGA neonates. We found no association between the severity of SGA and NEC.

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“…Maternal preeclampsia appears to be frequently associated with latent or mild fetal hypoxia, sufficient to trigger an EP response but no change in the other biochemical indicators of asphyxia was seen except for pH which was slightly lower than in controls. Recent studies on fetal aortic blood flow in preeclampsia suggest that the supply of oxygenated blood to abdominal organs-may be compromised (33). This would include the liver, which is the known "sensor" organ for EP response and the site of fetal EP synthesis (34).…”

Section: Discussionmentioning

confidence: 99%

Cord Plasma Vasopressin, Erythropoietin, and Hypoxanthine as Indices of Asphyxia at Birth

et al. 1988

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ABSTRACT. To assess the value of cord plasma arginine vasopressin (AVP), erythropoietin (EP), and hypoxanthine (HX) as indices of asphyxia, we studied 62 infants of mothers with preeclampsia, 34 acutely asphyxiated infants, with 5-min Apgar score 5 6 and/or umbilical arterial pH 57.05, and 38 control infants. Umbilical arterial AVP in the asphyxia group (geometric mean; 95% confidence interval: 180; 92-350 pg/ml) was higher than in the control group (23; 8-66, p = 0.002) and correlated with umbilical arterial pH ( r = -0.447, p = 0.028). AVP levels in the preeclampsia group did not differ from controls. Cord venous E P was higher in infants delivered by elective cesarean section from women with severe preeclampsia (115; 75-177 mU/ml, p < 0.001) than in control infants (23; 18-27); in the whole group EP correlated with pH (r = -0.493, p < 0.001). E P in the asphyxia group was similar (46; 35-65) to controls (40; 33-47) and did not correlate with pH. Cord arterial HX in the preeclampsia group was similar to controls (12.3; 9.5-16.0 pmol/liter), but elevated in the asphyxia group (23.7; 17.6-31.8, p = 0.001), in which HX correlated with pH ( r = 0.558, p = 0.008) and AVP ( r = 0.588, p = 0.005). E P did not correlate with AVP or HX in any group, nor did any of the variables correlate with the Apgar score. We conclude that cord plasma AVP and HX reflect acute asphyxia, whereas E P is elevated after more prolonged hypoxia. (Pediatr Res 24: 490-494,1988) Abbreviations AVP, arginine vasopressin EP, erythropoietin HX, hypoxanthine Fetal asphyxia and delivery trigger a rapid increase in the secretion of several "stress" hormones, e.g. catecholamines, glucocorticoids, ACTH, p-endorphin, and AVP, which in turn mediate the cardiovascular and metabolic adaptation to asphyxia (4-6). A more specific response to hypoxia is an increase in the synthesis of EP, followed by elevation of plasma levels (7,8). If tissue hypoxia becomes more severe, cellular ATP concentrations cannot be maintained, and increased concentrations of the purine nucleotide catabolic products, HX, xanthine, and uric acid, appear in body fluids (9).The aim of our study was to assess if three components of this physiological response, AVP, EP, and HX, could be useful as biochemic indices of the severity of asphyxia. Two different clinical conditions were studied: acute severe birth asphyxia and maternal preeclampsia, the latter as an example of a chronic but less severe compromise in fetal oxygen and nutrient supply.

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Doppler studies in the growth retarded fetus and prediction of neonatal necrotising enterocolitis, haemorrhage, and neonatal morbidity.

Cited by 255 publications

References 18 publications

Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses

Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses

Necrotizing Enterocolitis in Small-for-Gestational-Age Neonates: A Matched Case-Control Study

Cord Plasma Vasopressin, Erythropoietin, and Hypoxanthine as Indices of Asphyxia at Birth

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