Document Detail


Prenatal detection of ischemic changes in the placenta of the growth-retarded fetus by Doppler flow velocimetry of the maternal uterine artery.
MedLine Citation:
PMID:  8377970     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the relationships among the pregnancy outcomes of growth-retarded fetuses, Doppler flow velocimetry of the fetomaternal circulation, and pathologic changes in the placenta. METHODS: Forty-seven fetuses confirmed to be growth-retarded by ultrasonographic biometry were monitored during pregnancy in terms of the resistance indexes of the maternal uterine, fetal umbilical, and fetal middle cerebral arteries. After delivery, the placentas were examined for pathologic changes such as infarction and villous ischemia. RESULTS: Compared with 23 fetuses with nonischemic placentas, 24 growth-retarded fetuses whose placentas showed ischemic lesions were more frequently delivered preterm (P < .001) and by cesarean for fetal distress (P < .01), and they also had lower mean pH, higher carbon dioxide pressure, and lower oxygen pressure values (P < .05). Compared with the fetal umbilical and middle cerebral artery resistance indexes, the uterine artery resistance index showed the highest sensitivity (91.7%), specificity (78.3%), and positive predictive value (81.5%) for detecting placental ischemic changes. Linear discriminative analysis also showed that the uterine artery resistance index had the strongest correlation (P < .00001) with the placental ischemic changes. CONCLUSION: Ischemia of the placenta is associated with an adverse pregnancy outcome in growth-retarded fetuses. The placental ischemic changes can be detected using Doppler flow velocimetry. Measurement of the uterine artery resistance index might be useful for determining the clinical management of growth-retarded fetuses.
Authors:
M Iwata; N Matsuzaki; I Shimizu; N Mitsuda; M Nakayama; N Suehara
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  82     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1993-10-21     Completed Date:  1993-10-21     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  494-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Pathology, Osaka Medical Center, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arteries / physiopathology,  ultrasonography
Blood Flow Velocity
Cerebral Arteries / physiopathology,  ultrasonography
Discriminant Analysis
Female
Fetal Growth Retardation / ultrasonography*
Humans
Ischemia / diagnosis*
Placenta / blood supply*,  pathology
Predictive Value of Tests
Pregnancy
Pregnancy Outcome
Sensitivity and Specificity
Ultrasonography, Prenatal*
Umbilical Arteries / physiopathology,  ultrasonography
Uterus / blood supply*
Vascular Resistance

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


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