Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction.
Ultraschall Med
; 44(1): 56-67, 2023 Feb.
Article
en En
| MEDLINE
| ID: mdl-34768305
ABSTRACT
PURPOSE:
To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). MATERIALS ANDMETHODS:
A prospective European multicenter observational study included women with a singleton pregnancy, 32+â0-36+â6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] <â10th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of >â40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (<â0.9) or abnormal (≥â0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements.RESULTS:
856 women had 2770 measurements; 696 (81â%) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7â%) a UCR ≥â0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30â% vs. 9â%, relative risk 3.2; 95â%CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67â% (95â%CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6â% (95â%CI 5-7â%). The risk of composite adverse outcome was similar using the first or subsequent UCR values.CONCLUSION:
An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7â% when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Nacimiento Prematuro
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Retardo del Crecimiento Fetal
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
Ultraschall Med
Año:
2023
Tipo del documento:
Article
País de afiliación:
Reino Unido