Reference ranges for serial measurements of blood velocity and pulsatility index at the intra‐abdominal portion, and fetal and placental ends of the umbilical artery

Acharya, Ganesh; Wilsgaard, Tom; Berntsen, Gro; Maltau, Jan Martin; Kiserud, Torvid

doi:10.1002/uog.1902

Cited by 118 publications

(89 citation statements)

References 28 publications

(39 reference statements)

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“…Deshmukh A et al reported that 64.30% of low diastolic flow group and 82.35% of ADF/RDF group had oligohydramnios. 11 In present study 82.6% of category II and 90 % of category III patients had oligohydramnios. In category III patients 70% had absent diastolic flow and 30% had reversal of flow and pregnancy was terminated.…”

Section: Discussionsupporting

confidence: 49%

Prediction of perinatal outcome with umbilical artery Doppler in IUGR fetuses- a prospective analytical study in a tertiary medical college in Tamilnadu, India

Rajarajeswari

Thendral

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Umbilical artery Doppler blood flow studies were a better predictor of neonatal outcome than estimated fetal weight alone in intrauterine growth restricted (IUGR) fetuses. Perinatal mortality and morbidity are increased if the umbilical artery Doppler abnormality worsens.Methods: This study was conducted in Department of Obstetrics and Gynaecology, Thanjavur medical college from August 2015 to August 2016. One hundred singleton pregnancies complicated by IUGR beyond 32 weeks were subjected for Doppler study of umbilical artery. Perinatal outcome in terms of baby outcome, birth weight, early neonatal death, admission in NICU and duration of admission in NICU were analysed.Results: The main indication of termination of pregnancy was oligohydramnios (70%). The other causes of termination were 8% for uncontrolled hypertension and 4 % for post term. 60 % were delivered vaginally and 40% by lower segment cesarean section. Various indication for LSCS were Non-reactive CTG, fetal distress, severe oligohydramnios and failed induction. 92% were delivered alive babies and 8% still born babies. Birth weight of the babies varied from 900gm to 2.5Kg. But patients with absent or reversed end diastolic flow in umbilical artery Doppler, 80% of the babies weighed less than 1.5Kg. Perinatal mortality in our study is 19% which includes 8% of intrapartum mortality and 11% of neonatal mortality and perinatal morbidity is 24%. When the diastolic flow in the umbilical artery is, absent or reversed, it is associated with increased perinatal mortality of 80%.Conclusions: The results of present study clearly demonstrated the efficacy of umbilical artery Doppler in predicting the fetal outcome. To improve the predictive value of this tool, a better method is needed to assess the wellbeing of the IUGR fetuses such as integrated antenatal test which combines BPP and Doppler study employing other vessels.

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Section: Discussionsupporting

confidence: 49%

Prediction of perinatal outcome with umbilical artery Doppler in IUGR fetuses- a prospective analytical study in a tertiary medical college in Tamilnadu, India

Rajarajeswari

Thendral

2017

Int J Reprod Contracept Obstet Gynecol

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“…placental blood flow represented an early event in the pathogenesis of IUGR (Acharya et al, 2005). In our cases, the mean gestational age of estimation of the UVVF in group 1 MCs was 24.6 weeks and the significant discordance of UVVF was already detected.…”

Section: Figurementioning

confidence: 43%

“…UVVF in normally developing and growth restricted fetuses were evaluated and were reported as significantly reduced in the restricted fetuses (Boito et al, 2002). Because UVVF can be significantly different among different fetuses -even at the same gestational age (Acharya et al, 2005) -it can be difficult to compare the UVVF between IUGR and AGA fetuses in singletons. The major advantage of the twin model for UVVF research is that it optimizes the effect of maternal confounding variables such as nutrition, hypertension, diabetes or smoking.…”

Section: Figurementioning

confidence: 99%

The Relationships of Umbilical Venous Volume Flow, Birthweight and Placental Share in Monochorionic Twin Pregnancies With and Without Selective Intrauterine Growth Restriction

Chang¹,

Chang

Chao

et al. 2011

Twin Res Hum Genet

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This study was conducted to investigate the relationship among umbilical venous volume flow, birthweight and placental share in monochorionic twins with or without selective growth restriction. Having excluded cases complicated with twin-to-twin transfusion syndrome and one co-twin suffering intrauterine fetal death, a total of 51 monochorionic twin pregnancies were divided into two groups as with (group 1) and without (group 2) selective intrauterine growth restriction. Umbilical venous volume flow was calculated by multiplying the umbilical vein cross-sectional area by half of the maximal velocity around mid-trimester. The placentas were cut along the vascular equator into two individual placental masses. The discordance of birthweight was calculated as [(birthweight of larger twin—birthweight of smaller twin)/birthweight of larger twin 100%]. The discordances of umbilical venous volume flow and placental share were calculated in a similar fashion. The median umbilical venous volume flow discordances (68.4% and 15.3% in groups 1 and 2 monochorionic twins, respectively) were similar and correlated well with the placental share discordances (66.6% and 18.5% in groups 1 and 2 monochorionic twins, respectively) but not with the birthweight discordance (28.6% and 6.4% in groups 1 and 2 monochorionic twins, respectively) in both groups. We concluded that the umbilical venous volume flow discordance reflects the placental share discordance rather than the birthweight discordance in monochorionic twin pregnancies.

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“…The pulsed-wave Doppler gate was positioned in one of the umbilical arteries with the insonation angle of < 30˚ and the sample volume encompassed the entire width of the vessel. If three similar consecutive waveforms were obtained, mean PI of these waveforms was used for the analysis [19]. We assessed MCA PI in the axial plane of the brain, including the thalamic and the sphenoid bone wings.…”

Section: Methodsmentioning

confidence: 99%

Assessment of ultrasound and Doppler parameters in the third trimester of pregnancy as predictors of adverse perinatal outcome in unselected pregnancies

Peixoto

Caldas²,

Silva³

et al. 2016

Ginekol Pol

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Objectives: The aim of the study was to investigate ultrasound and Doppler parameters in the third trimester of pregnancy as possible predictors of adverse perinatal outcome in unselected pregnancies. Material and methods:We performed a retrospective cross-sectional study including unselected pregnant women between 27 and 36 + 6 weeks of gestation. The following ultrasound and Doppler parameters were assessed: estimated fetal weight (EFW) [g], EFW percentile, placental maturity grade (Grannum classification), single vertical deepest pocket (SVDP) of amniotic fluid [cm], amniotic fluid index (AFI) [cm], mean uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, middle cerebral artery (MCA) PI, MCA peak systolic velocity (PSV) [cm/s], and cerebroplacental ratio (CPR). Adverse perinatal outcome was defined as Apgar score of < 7 at 1 min, birth weight of < 2500 g at delivery, and gestational age of < 37 weeks at delivery. The unpaired t test was used to compare the groups.Results: AFI (p = 0.01), mean UtA PI (p = 0.04) and mean UA PI (p = 0.03) were significantly different with regard to the Apgar score at 1 min. EFW, EFW percentile, SVDP of amniotic fluid, AFI, mean UtA PI, UA PI, and MCA PI were significantly different (p < 0.001) in terms of birth weight. Placental maturity grade (p = 0.02), SVDP of the amniotic fluid (p < 0.001), AFI (p < 0.001), mean UtA PI (p < 0.001), UA PI (p = 0.001), and MCA PI (p < 0.001) were significantly different as far as gestational age at delivery is concerned. Conclusion:Ultrasound and Doppler parameters may predict adverse perinatal outcomes in unselected pregnancies in the third trimester of pregnancy.

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Reference ranges for serial measurements of blood velocity and pulsatility index at the intra‐abdominal portion, and fetal and placental ends of the umbilical artery

Abstract: Objective

Cited by 118 publications

References 28 publications

Prediction of perinatal outcome with umbilical artery Doppler in IUGR fetuses- a prospective analytical study in a tertiary medical college in Tamilnadu, India

Prediction of perinatal outcome with umbilical artery Doppler in IUGR fetuses- a prospective analytical study in a tertiary medical college in Tamilnadu, India

The Relationships of Umbilical Venous Volume Flow, Birthweight and Placental Share in Monochorionic Twin Pregnancies With and Without Selective Intrauterine Growth Restriction

Assessment of ultrasound and Doppler parameters in the third trimester of pregnancy as predictors of adverse perinatal outcome in unselected pregnancies

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