Document Detail

Clinical significance of absent or reversed end diastolic velocity waveforms in umbilical artery.
MedLine Citation:
PMID:  7996959     Owner:  NLM     Status:  MEDLINE    
Doppler ultrasound provides a non invasive method to assess fetal haemodynamics. We looked at the outcome of doppler velocimetry of the umbilical artery in three groups of pregnancies: those with positive end diastolic velocities (PED; n = 214), absent end diastolic velocities (AED; n = 178) and reversed end diastolic velocities (RED; n = 67). We collected our data from 9 European centers. Logistic regression showed that compared with pregnancies with hypertension only, pregnancies complicated by intra uterine growth retardation (IUGR) had a higher risk of developing absent or reversed end diastolic velocity waveforms (ARED) flow. ARED flow in the umbilical artery (odds ratio: OR = 3.1). Pregnancies complicated by both IUGR and hypertension had an even higher risk (OR = 7.4). Maternal age and smoking habits did not influence the risk of developing ARED flow. The overall perinatal mortality rate was 28%. Significantly more neonates in the ARED flow group needed admittance to the neonatal intensive care unit (PED group 60%, AED group 96%, RED group 98%). The OR for perinatal mortality in pregnancies complicated by AED flow was 4.0 and in RED flow was 10.6, compared with PED flow, even after adjustment for menstrual age. ARED flow in the umbilical artery did not influence the risk of respiratory distress syndrome or necrotising enterocolitis of the neonate, but ARED flow significantly influenced the risk of cerebral haemorrhage, anaemia, or hypoglycaemia. We advise that pregnancies complicated by IUGR and/or hypertension should be followed up with doppler velocimetry to trace utero-placental problems as early as possible. A caesarean section is recommended in all pregnancies complicated by ARED flow if the gestational age and predicted neonatal weight can be handled by the local neonatal intensive care unit.
V H Karsdorp; J M van Vugt; H P van Geijn; P J Kostense; D Arduini; N Montenegro; T Todros
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  344     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-01-19     Completed Date:  1995-01-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1664-8     Citation Subset:  AIM; IM    
Department of Obstetrics and Gynaecology, Free University Hospital, Amsterdam, The Netherlands.
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MeSH Terms
Fetal Death
Fetal Growth Retardation / diagnosis*
Gestational Age
Hypertension / diagnosis
Laser-Doppler Flowmetry*
Maternal Age
Pregnancy Complications, Cardiovascular / diagnosis*
Prospective Studies
Risk Factors
Umbilical Arteries*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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