| Doppler application in the delivery timing of the preterm growth-restricted fetus: another step in the right direction. | |
| | |
MedLine Citation:
|
PMID: 14770388 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
This article provides an opinion on a study of relationships between umbilical artery (UA) Doppler, ductus venosus (DV) Doppler, fetal heart rate variation, and perinatal outcome in preterm, intrauterine growth-restricted (IUGR) fetuses published in the same issue of this journal by Bilardo and coworkers. Recent evidence on venous Doppler surveillance in preterm IUGR fetuses was also reviewed and discussed in the context of the study with a special emphasis on delivery timing. A search was conducted through MEDLINE and eight articles with similar inclusion criteria and reporting format of outcomes were identified. Numbers for perinatal mortality, intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia and necrotizing enterocolitis (NEC) were extracted for cases where Doppler status was recorded in an identical format. Proportional distribution of outcomes was compared for fetuses with normal DV Doppler velocimetry, absent or reversed UA end-diastolic velocity (UA A/REDV), elevated DV Doppler index (abnormal DV) and absence or reversal of atrial velocity in the DV (DV-RAV). A total of 320 fetuses with normal and 202 with elevated DV Doppler indices were extracted. Of these fetuses, 101 with UA A/REDV only and 34 with DV-RAV were identified. Perinatal mortality was 5.6% (16/282) with normal DV, 11.9% (12/101) with UA A/REDV, 38.8% (64/165) with abnormal DV and 41.2% (7/17) with DV-RAV. With the exception of NEC, all complications were significantly more frequent with abnormal DV. With normal venous Doppler neonatal deaths account for most of the perinatal mortality, while with abnormal DV stillbirths and neonatal mortality are similar contributors to the significantly increased perinatal mortality. In conclusion, UA Doppler is a placental function test that provides important diagnostic and prognostic information in preterm IUGR. DV Doppler effectively identifies those preterm IUGR fetuses that are at high risk for adverse outcome (particularly stillbirth) at least 1 week before delivery, independent of the UA waveform. Relationships between perinatal outcome, arterial and venous Doppler status and gestational age require ongoing observational research effort. Randomized management trials are necessary to verify that delivery timing based on venous Doppler will impact on outcome in preterm IUGR. |
| | |
Authors:
|
A A Baschat |
Related Documents
:
|
16026398 - Uterine artery doppler velocimetry for the detection of adverse obstetric outcomes in p... 17029308 - Fetal middle cerebral to uterine artery pulsatility index ratios in normal and pre-ecla... 1823218 - Vascular prostacyclin production in andean women with pregnancy-induced hypertension. 9565138 - Three-dimensional ultrasonographic assessment of the umbilical cord during the 2nd and ... 14642038 - Laparoscopic management of hydronephrosis in a woman with rare genitourinary anomalies:... 17473328 - The proper time for hearing screening in newborns. |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 23 ISSN: 0960-7692 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2004 Feb |
Date Detail:
|
Created Date: 2004-02-10 Completed Date: 2004-05-24 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
|
Languages: eng Pagination: 111-8 Citation Subset: IM |
Copyright Information:
|
Copyright 2004 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
|
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland, Baltimore, Baltimore, MD 21201-1703, USA. aabaschat@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Biomedical Research Delivery, Obstetric / methods* Disease Progression Female Fetal Growth Retardation / ultrasonography* Gestational Age Humans Pregnancy Pregnancy Outcome Time Factors Ultrasonography, Doppler / methods Ultrasonography, Prenatal / methods* Umbilical Arteries / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postop...
Next Document: Relationship between monitoring parameters and perinatal outcome in severe, early intrauterine growt...