Umbilical Artery Blood Flow Velocity Waveforms and Associations with Fetal Abnormality

Hata, Kohkichi; Hata, Toshiyuki; Senoh, Daisaku; Aoki, Showa; Takahashi, Osamu; Kitao, Manabu

doi:10.1159/000293651

Cited by 8 publications

(3 citation statements)

References 13 publications

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“…Our findings are compatible with those of Hata et al, 15 who found normal umbilical artery resistance index (RI) values in six of seven fetuses with cardiac defects. Their results differed somewhat from ours in COPEL ET AL 325 that five of six fetuses with CHO and normal umbilical artery RI values survived, and the only fetus with an elevated value died.…”

Section: Discussionsupporting

confidence: 93%

Can umbilical artery pulsatility index predict the outcome of fetuses with structural heart disease?

Copel

Jc²,

Kleinman³

1991

Journal of Ultrasound in Medicine

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Umbilical artery Doppler waveforms have been suggested to demonstrate diminished end-diastolic velocities in anomalous fetuses. We evaluated 11 fetuses with antenatally diagnosed congenital heart disease (CHD) and compared them to a normal population. Fetuses with CHD were studied once each and ranged in age from 19 to 32 weeks gestation. Eight had normal chromosomes, and three were aneuploid. The pulsatility index (PI) was elevated (above the 90th percentile for gestational age) in 3/11 CHD fetuses (P = NS). Elevated PI did not discriminate well between those with fatal and nonfatal lesions. Although all three fetuses with elevated PI had fatal disease, five of eight fetuses with fatal anomalies had normal PI values. We conclude that, while umbilical artery PI values were elevated in a subgroup of affected fetuses, this was not clinically helpful.

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Section: Discussionsupporting

confidence: 93%

Can umbilical artery pulsatility index predict the outcome of fetuses with structural heart disease?

Copel

Jc²,

Kleinman³

1991

Journal of Ultrasound in Medicine

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“…At the same time, abnormal umbilical artery Doppler is not pathognomonic of placental dysfunction, as certain genetic conditions (e.g. triploidy) may mimic early‐onset placental FGR, including the presence of abnormal umbilical artery Doppler, most likely due to concomitant placental insufficiency secondary to the abnormal placental karyotype 34,277‐279 . In contrast to umbilical artery Doppler, uterine artery Doppler is less likely to be abnormal among fetuses with FGR and abnormal karyotype, and should therefore be considered to be more specific for primary placental FGR, especially in the presence of abnormal angiogenic markers in maternal blood 34,107,280 …”

Section: What Kind Of Investigations Should Be Performed When Fetal Gmentioning

confidence: 99%

FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: Best practice advice for screening, diagnosis, and management of fetal growth restriction

Melamed

Baschat

Yinon

et al. 2021

Intl J Gynecology & Obste

268

218

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“…hypothesized that the asymmetric pattern of FGR fetuses with abnormal karyotype may be due to concomitant placental insufficiency secondary to the abnormal placental karyotype, which is supported by reports of high rate of abnormal umbilical artery Doppler in fetuses with abnormal karyotype. [94][95][96][97] It should be emphasized, however, that unlike umbilical artery Doppler, the uterine artery Doppler is likely to be normal among fetuses with FGR and abnormal karyotype. 94,98 Thus, in fetuses with early-onset severe FGR (with or without abnormal umbilical artery Doppler), the presence of an unusually high HC/AC ratio (>1.4) and normal uterine artery Doppler is associated with increased risk of abnormal karyotype, especially triploidy.…”

Section: Expert Reviewsmentioning

confidence: 99%

Fetal growth velocity and body proportion in the assessment of growth

Hiersch

Melamed

2018

American Journal of Obstetrics and Gynecology

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Fetal growth restriction implies failure of a fetus to meet its growth potential and is associated with increased perinatal mortality and morbidity. Therefore, antenatal detection of fetal growth restriction is of major importance in an attempt to deliver improved clinical outcomes. The most commonly used approach towards screening for fetal growth restriction is by means of sonographic fetal weight estimation, to detect fetuses small for gestational age, defined by an estimated fetal weight <10th percentile for gestational age. However, the predictive accuracy of this approach is limited both by suboptimal detection rate (as it may overlook non-small-for-gestational-age growth-restricted fetuses) and by a high false-positive rate (as most small-for-gestational-age fetuses are not growth restricted). Here, we review 2 strategies that may improve the diagnostic accuracy of sonographic fetal biometry for fetal growth restriction. The first strategy involves serial ultrasound evaluations of fetal biometry. The information obtained through these serial assessments can be interpreted using several different approaches including fetal growth velocity, conditional percentiles, projection-based methods, and individualized growth assessment that can be viewed as mathematical techniques to quantify any decrease in estimated fetal weight percentile, a phenomenon that many care providers assess and monitor routinely in a qualitative manner. This strategy appears promising in high-risk pregnancies where it seems to improve the detection of growth-restricted fetuses at increased risk of adverse perinatal outcomes and, at the same time, decrease the risk of falsely diagnosing healthy constitutionally small-for-gestational-age fetuses as growth restricted. Further studies are needed to determine the utility of this strategy in low-risk pregnancies as well as to optimize its performance by determining the optimal timing and interval between exams. The second strategy refers to the use of fetal body proportions to classify fetuses as either symmetric or asymmetric using 1 of several ratios; these include the head circumference to abdominal circumference ratio, transverse cerebellar diameter to abdominal circumference ratio, and femur length to abdominal circumference ratio. Although these ratios are associated with small for gestational age at birth and with adverse perinatal outcomes, their predictive accuracy is too low for clinical practice. Furthermore, these associations become questionable when other, potentially more specific measures such as umbilical artery Doppler are being used. Furthermore, these ratios are of limited use in determining the etiology underlying fetal smallness. It is possible that the use of the 2 gestational-age-independent ratios (transverse cerebellar diameter to abdominal circumference and femur length to abdominal circumference) may have a role in the detection of mild-moderate fetal growth restriction in pregnancies without adequate dating. In addition, despite their limited predictive accuracy, t...

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Umbilical Artery Blood Flow Velocity Waveforms and Associations with Fetal Abnormality

Cited by 8 publications

References 13 publications

Can umbilical artery pulsatility index predict the outcome of fetuses with structural heart disease?

Can umbilical artery pulsatility index predict the outcome of fetuses with structural heart disease?

FIGO (International Federation of Gynecology and Obstetrics) initiative on fetal growth: Best practice advice for screening, diagnosis, and management of fetal growth restriction

Fetal growth velocity and body proportion in the assessment of growth

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