Prognostic significance of the interaction between abnormal umbilical and middle cerebral artery Doppler velocimetry in pregnancies complicated by fetal growth restriction.
Acta Obstet Gynecol Scand
; 88(2): 159-66, 2009.
Article
en En
| MEDLINE
| ID: mdl-19169929
ABSTRACT
OBJECTIVE:
To evaluate the prognostic significance of the interaction between umbilical artery (UA) and middle cerebral artery (MCA) Doppler measurements in pregnancies complicated by fetal growth restriction (FGR).DESIGN:
Cohort study.SETTING:
Third-level Perinatology Center in Northern Italy. POPULATION A study of 184 singleton pregnancies at 24-35 weeks' gestational age complicated by FGR and abnormal UA Doppler measurements.METHODS:
FGR was diagnosed by serial ultrasonograms. Neonatal brain damage was defined as the presence of cystic leukomalacia or grade III-IV intraventricular hemorrhage. MAIN OUTCOMEMEASURES:
Perinatal death and neonatal brain damage.RESULTS:
The prevalence of fetal/neonatal death or brain damage was 18.2% (16/88) in pregnancies with UA absent/reversed diastolic flow and 4.2% (4/96) in those with increased UA Doppler pulsatility. Stepwise logistic regression identified decreasing gestational age (OR=1.75, 95% confidence interval, CI=1.35-2.22) and absent/reversed UA blood flow (OR=3.34, 95% CI=1.1-10.9) as predictors of fetal/neonatal death or brain damage. A MCA pulsatility index below the 10th percentile was a risk factor for fetal/neonatal death or brain damage among women with absent/reversed UA diastolic flow (14/53 as compared to 2/35; OR=5.9, CI =1.4-40.3) but not in pregnancies with forward velocity (1/33 as compared to 3/63; OR=0.63, 95% CI=0.02-6.13, Synergy index=27.7, p=0.007).CONCLUSIONS:
In pregnancies complicated by FGR and absent/reversed UA end diastolic flow, vasodilatation of the MCA is a risk factor for neonatal death or brain damage.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Arterias Umbilicales
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Velocidad del Flujo Sanguíneo
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Ultrasonografía Prenatal
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Arteria Cerebral Media
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Retardo del Crecimiento Fetal
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Enfermedades del Prematuro
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Newborn
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Pregnancy
Idioma:
En
Año:
2009
Tipo del documento:
Article