Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Joern, H.; Schroeder, W.; Saßen, Regine; Rath, Werner

doi:10.1515/jpme.1997.25.4.325

Cited by 6 publications

(7 citation statements)

References 15 publications

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“…Present study result contrasts to the study result of Mariola Ropacka-Lesiak [7] et al who concluded that there were no statistically significant differences occur in majority of parameters that characterize the neonatal outcome between the groups with normal and abnormal Middle cerebral artery pulsatility index (MCA PI). The results of the present study is similar to the work of other authors like Mari G et al [15]who suggested that small for gestational age fetus with a normal middle cerebral artery Pulsatility Index was at lower risk of abnormal fetal outcome than the fetus with abnormal Pulsatility index values and Joern et al [16] who assessed the predictive value of a combined analysis of blood flow in the aorta, umbilical artery, and Middle cerebral artery in predicting the birth weight of small for gestational age infant.…”

Section: Issn-2321-127xsupporting

confidence: 92%

Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome

et al. 2017

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Aim: This study was to evaluate the applicability of Doppler velocimetry to determine its correlation with fetal outcome in dichorionic twin pregnancies. Material and methods: Doppler examination of the umbilical artery (UA) and middle cerebral artery (MCA) was performed in 57 twin pairs. Abnormal values of the umbilical artery pulsatility index (PI), umbilical artery Resistive index (RI) were above the 95th percentile and below 5th percentile for the Middle cerebral artery pulsatility index (MCA PI) and Middle cerebral artery resistivity index (MCA RI) for gestational week. The difference of UA PI ≥0.5 in twin pairs was considered abnormal. Results: 33 subjects had a fetal discordance of greater than 15%. Birth weight was found to be significantly lower in subjects with Umbilical artery PI greater than 95 th percentile for gestational age (p=0.014). Abnormal MCA RI (P=0.018) and Umbilical artery RI values above 95 th percentile was significantly associated with increased risk of IUGR (intra uterine growth restriction) (P=0.036) and NICU (Neonatal intensive care unit) admission (P=0.005). Increased Umbilical artery PI values above 95 th percentile was significantly associated with IUGR (P=0.003). Increased Umbilical Artery systolic/diastolic ratio above 95 th percentile was significantly associated with IUGR (P=0.002), NICU admission (P=0.026) and still birth (P=0.026). Abnormal cerebra-umbilical ratio (<1.08) was significantly associated with IUGR (P=0.001) and still birth (P=0.025). Difference in pulsatility index of umbilical artery of both fetus (P1-P2 >0.5) was significantly correlated with increased degree of birth weight discordance of the twins, IUGR (P=0.001) and still birth (P=0.001). Conclusion: Abnormal Doppler values in discordant twin fetus are more likely to be associated with abnormal fetal outcome.

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Section: Issn-2321-127xsupporting

confidence: 92%

Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome

et al. 2017

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“…An own study demonstrated [15] that in cases of multiple pregnancies, Doppler velocimetry is superior to fetal biometry with respect to the identification of IUGR; here, the sensitivity of Doppler velocimetry was 76% and that of biometry only 34%. The same applies to the comparison of the sensitivities of Doppler velocimetry (60%) and the nonstress test (10%) regarding the identification of an intrauterine asphyxia [15].…”

Section: Introductionmentioning

confidence: 75%

“…The same applies to the comparison of the sensitivities of Doppler velocimetry (60%) and the nonstress test (10%) regarding the identification of an intrauterine asphyxia [15]. The problems of fetal biometry in multiple gestation [16,17] and the small predictive value of the nonstress test are well known from other studies [18,19].…”

Section: Introductionmentioning

confidence: 92%

Correlation of Doppler Velocimetry Findings in Twin Pregnancies Including Course of Pregnancy and Fetal Outcome

Joern¹,

Rath²

2000

Fetal Diagn Ther

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Objective: Subject of the study was the significance of umbilical artery Doppler velocimetry findings for the further course of pregnancy and fetal outcome in cases of twin pregnancies. Methods: In 206 cases of twin pregnancy, the umbilical artery was examined using Doppler velocimetry in the median 9 days prior to delivery, and the result was correlated with the further course of pregnancy and fetal outcome. 174 pregnancies showed normal Doppler findings of the umbilical artery (group A), 32 twin pregnancies showed pathological Doppler findings of at least one twin (group B). The median of the maternal age and the parity between the groups were not different. Results: In group B (pathological Doppler findings), intrauterine growth retardation and pre-eclampsia occurred 5 times more often than in group A (normal Doppler findings). The total rate of cesarean sections was not different between the study populations; the rate of deliveries by cesarean section in group B was significantly increased by a factor of 2.4 due to a pathological CTG. The median birth weight and the gestational age at birth were significantly lower in group B (1,660 g; 35 weeks) as compared to group A (2,460 g; 37 weeks; p < 0.001). In group B, the rate of premature deliveries up to reaching the 34th week of gestation was 3.4 times higher; the rate of SGA newborns was 6.3 times higher. Perinatal mortality was increased by a factor of 1.5 in group B compared to group A. Conclusion: The Doppler velocimetry findings have considerable effects on the further course of a multiple pregnancy. In case of pathological Doppler findings, early hospitalization and close monitoring of the pregnancy should be performed. In cases of additional pathological findings (maternal illness, pathological Doppler findings of fetal blood vessels), termination of the pregnancy has to be considered.

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“…Doppler ultrasound is one of the most accurate ways of monitoring individual fetuses in a multiple pregnancy (Eganhouse & Petersen, 1998). Doppler velocimetry can detect blood flow patterns in the fetal blood vessels and placenta to assess for problems (Joern, Schroeder, Sassen, & Rath, 1997;Malcus, 2004).…”

Section: Fetal Monitoring For Multiple Fetusesmentioning

confidence: 99%

Childbirth Education for Multiple Pregnancy

Montgomery¹,

Cubera²,

Belcher³

et al. 2005

jpe

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Women with a multiple pregnancy have unique learning needs in preparing for birth. This paper explores the issues relevant to women with a multiple pregnancy to support a positive birth experience. One of the foundations of childbirth education and nursing care is to provide the individual woman and her family with knowledge regarding the birth process, what to expect, and how to cope with labor and birth. Education also focuses on caring for the newborns after birth and how to manage in the early days at home. However, traditional childbirth education classes, which meet in a series of evenings or Saturdays, may not meet the needs of women with a multiple pregnancy. In addition, because of the differences in care that exist for women with a multiple pregnancy, new paradigms for childbirth education are needed to meet the learning needs of these families. The purpose of this paper is to provide information to the childbirth educator on the differences in care women with a multiple pregnancy can expect and to suggest strategies to meet the childbirth education needs of these families.

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Predictive value of a single CTG, ultrasound and Doppler examination to diagnose acute and chronic placental insufficiency in multiple pregnancies

Cited by 6 publications

References 15 publications

Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome

Doppler velocimetry in dichorionic twin pregnancies and its correlation with various fetal outcome

Correlation of Doppler Velocimetry Findings in Twin Pregnancies Including Course of Pregnancy and Fetal Outcome

Childbirth Education for Multiple Pregnancy

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