Document Detail


Umbilical artery PI and fetal abdominal circumference in isolated gastroschisis.
MedLine Citation:
PMID:  21308833     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To investigate abdominal circumference growth and umbilical PI changes with gestation in fetuses with isolated gastroschisis, and determine whether a relationship exists between umbilical artery PI (UAPI) and the fetal abdominal circumference (AC). METHODS: Data from 58 pregnancies with prenatally diagnosed isolated gastroschisis were included from 24-36 weeks. Z-scores were calculated with respect to expected UAPI values in normal pregnancies after log-transformation. For AC, z-scores were calculated with respect to expected size in normal pregnancies according to a standard chart. Functional linear discriminant analysis (FLDA) was applied to generate 50(th) , 5(th) and 95(th) percentile curves for both AC and UAPI with gestation in gastroschisis. These curves were compared with the standard curves, as were the means. UAPI was also plotted against AC. For this relationship, a robust Spearman correlation coefficient was obtained with FLDA. RESULTS: There was a highly significant negative correlation between UAPI and AC, normalised for gestation using z-scores (median correlation coefficient = -0.289 / median p-value = 2.3e-5). Moreover, compared to standard curves AC is lower and UAPI higher in the gestation range studied. Both the AC and UAPI curves showed a significantly different rate of change with gestation compared with the normal ranges. The mean values for gastroschisis compared with the standard AC and UAPI range curves were significantly different for AC throughout the gestation range, and for UAPI from 32 weeks. CONCLUSIONS: In fetal gastroschisis, it is well known that AC tends to be smaller, though UAPI has not been reported to be abnormal in any consistent way. There is a clear relationship between the degree of smallness of the baby's abdominal circumference for gestation and the umbilical PI. This is not the case for normally grown babies. The data suggest that the growth restriction seen in gastroschisis may be explained by hypoxia, and not simply because of the classical explanation of extra-abdominal displacement of the abdominal viscera. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
U Hussain; A Daemen; H Missfelder-Lobos; B De Moor; D Timmerman; T Bourne; C Lees
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-24
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-2-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Division of Fetal Medicine, Addenbrookes Hospital, Cambridge UK.
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