Document Detail


Arterial and venous Doppler in the diagnosis and management of early onset fetal growth restriction.
MedLine Citation:
PMID:  16280208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Key issues in the management of early onset fetal growth restriction (IUGR<34 weeks) are accurate diagnosis and assessment of fetal well-being to optimize timing of delivery by weighing fetal vs. neonatal risks. Cardiovascular, behavioral and fetal heart rate patterns in IUGR follow a predictable progression that corresponds with the severity of compromise. Umbilical artery (UA) Doppler primarily serves as a placental function test providing insufficient information to solely direct perinatal management. Venosus Doppler is an independent predictor of stillbirth and acidemia and needs to be examined when the UA index is elevated, especially if end-diastolic velocities are absent. Neonatal outcomes are primarily determined by gestational age and their antenatal prediction is too ineffective to guide management. Abnormal venous Doppler, biophysical profile score and mean minute variation of the fetal heart rate are strong predictors of fetal compromise therefore favoring delivery. Randomized trials indicate that delayed delivery has little effects on short-term outcome while producing a trend towards improved early childhood neurodevelopment. This stresses the need for excellent fetal surveillance techniques and their ongoing investigation through randomized management trials.
Authors:
Ahmet Alexander Baschat
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Publication Detail:
Type:  Journal Article; Review     Date:  2005-11-08
Journal Detail:
Title:  Early human development     Volume:  81     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-29     Completed Date:  2006-02-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  877-87     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Prenatal Medicine, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany. aabaschat@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Growth Retardation / diagnosis*,  therapy*,  ultrasonography
Humans
Practice Guidelines as Topic
Pregnancy
Ultrasonography, Doppler* / methods

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