Document Detail


Fetal arterial and venous Doppler in growth restricted fetuses for the prediction of perinatal complications.
MedLine Citation:
PMID:  21043384     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fetal arterial and venous Doppler is a useful tool for the monitoring of growth restricted fetuses. Our aim in this study was to compare outcomes when fetuses were grouped according to the combinations of the Doppler results and also according to each vessel Doppler. Deliveries during the period 2002-2008 were reviewed retrospectively and cases with a birth weight less than the 10th percentile were selected for the study. Cases with congenital malformations or chromosomal abnormalities were excluded. Cases were then grouped according to umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV) Doppler results. Two hundred fifty-five cases were selected for the study. The perinatal mortality rate was 9.8% (11 prenatal and 14 neonatal). In the presence of absent or reverse flow in UA, fetal death and neonatal complication rates were higher. In the fetuses having reverse or absent "a" wave, there were findings of metabolic deterioration. Absent-reverse UA end-diastolic flow increased the odds ratios of perinatal and fetal death, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), respiratory distress syndrome (RDS), and need for neonatal intensive care unit (NICU) (2.81, 5.94, 10.82, 5.79, 5.19, and 11.60, respectively). Absent/reverse "a" wave in DV increased the odds ratio of perinatal death, fetal death, neonatal death, RDS, and abnormal pH (19.89, 18.06, 12.50, 8.29, and 9.67, respectively). For prediction of fetal metabolic status, DV Doppler is a reliable tool. However, when perinatal complications are considered, this finding for intervention to delivery is a late point. Therefore, when reverse end-diastolic flow in the UA is observed, decision-to-delivery should be taken in order to avoid metabolic deterioration and increased postpartum death.
Authors:
Ozgür Ozyüncü; Burcu Saygan-Karamürsel; Didem Armangil; Lütfü S Onderoğlu; Sule Yiğit; Melih Velipaşaoğlu; Ozgür Deren
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Turkish journal of pediatrics     Volume:  52     ISSN:  0041-4301     ISO Abbreviation:  Turk. J. Pediatr.     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-11-03     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417505     Medline TA:  Turk J Pediatr     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  384-92     Citation Subset:  IM    
Affiliation:
Maternal Fetal Medicine Unit, Department of Obstetrics and Gynecology, Hacettepe University Faculty of Medicine, Turkey.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Arteries / abnormalities,  ultrasonography
Blood Flow Velocity
Chi-Square Distribution
Female
Fetal Growth Retardation / physiopathology,  ultrasonography*
Fetus / blood supply
Humans
Infant, Newborn
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Retrospective Studies
Sensitivity and Specificity
Statistics, Nonparametric
Ultrasonography, Doppler*
Ultrasonography, Prenatal / methods*

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