A comparative study of three indices of umbilical blood flow in relation to prediction of growth retardation

Mulders, Léon G.M.; Wijn, Pff Pieter; Jongsma, H.W.; Hein, P.R.

doi:10.1515/jpme.1987.15.1.3

Cited by 27 publications

(7 citation statements)

References 12 publications

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“…However, Narula et al did not specify the criteria of combined indices of the UA. The findings in the present study are in consonance with the findings of Mulders et al [8] who found a sensitivity of 53.3 % and a specificity of 87.9 % for the UA PI at around 32-34 weeks of pregnancy. In the present study, the findings at the first visit (23-27 weeks) resemble the findings of Mulders et al Except for Narula et al [7] who had indicated no specific criteria, all the studies show that the UA PI is relatively a more specific criteria than a sensitive criteria.…”

Section: Discussionsupporting

confidence: 93%

Comparison of Diagnostic Efficacy of Umbilical Artery and Middle Cerebral Artery Waveform with Color Doppler Study for Detection of Intrauterine Growth Restriction

Khanduri

Parashari

Bashir

et al. 2013

J Obstet Gynecol India

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Background and Objectives Intrauterine growth restriction is associated with increased perinatal mortality and morbidity, possibly extending also in adult life, as compared to fetuses and newborns presenting characteristics of normal growth. The present study had been planned to measure the pulsatility index (PI) and resistive index of the middle cerebral artery with pulsatility and resistive index of the umbilical artery in predicting fetal growth restriction. Materials and Methods A total of 60 pregnant women with a clinical history and grayscale-screened patients were taken for Doppler analysis, and a final comparison of accuracy of Doppler indices was done with perinatal outcome. Statistical Analysis The statistical analysis was done using the Statistical Package for Social Sciences version 15.0 statistical analysis software. The values were represented in number (%) and mean ± SD. Observation and Results The umbilical artery PI had maximum sensitivity at the third visit (32-37 weeks) and maximum specificity also at the third visit (32-37 weeks). The umbilical artery resistive index had maximum sensitivity at the second visit (28-32 weeks) and maximum specificity at the third visit (32-37 weeks). The MCA PI had an overall diagnostic accuracy of 52.8 %. Conclusion The PI of the umbilical artery was more sensitive than the PI of the middle cerebral artery. Umbilical artery PI has the maximum overall diagnostic accuracy of 75 %.

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Section: Discussionsupporting

confidence: 93%

Comparison of Diagnostic Efficacy of Umbilical Artery and Middle Cerebral Artery Waveform with Color Doppler Study for Detection of Intrauterine Growth Restriction

Khanduri

Parashari

Bashir

et al. 2013

J Obstet Gynecol India

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“…8 Although most studies have addressed placental resistance as related by the S/D (A/B) ratio, some have specifically dealt with Rl 8 • 12 because it avoids pitfalls of variation that occur with the gestational-age-dependent S/ D. 12 In relation to actual outcome, when allowances for gestational age are taken, there may be no inherent differences in predictability among the three indices. 6 Our study confirmed that intraobserver and interobserver continuous-wave Doppler interpretations had a high degree of reproducibility. The greatest contributor to reading variation is between waveforms tem-poraUy separated.…”

Section: Discussionsupporting

confidence: 82%

Precision of umbilical artery Doppler studies. Intraobserver, interobserver, and biologic variability of fetal Doppler velocimetry.

Thomas

Peng²,

Eglinton³

et al. 1991

Journal of Ultrasound in Medicine

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The use of Doppler ultrasound to study fetal blood flow has become commonplace, despite the lack of detailed evaluation of the testing tool for precision. In evaluation of 25 patients, no significant intraobserver differences were found between readings on an individual waveform, nor were there significant differences between different observers on individual waveforms. Temporally separated waveforms within a 30-minute window gave the greatest variation. A multi-way analysis of variance noted significant differences in this category only. This study confirmed the precision of measurements by a single observer and between observers. Only biological alterations over time displayed significant variability.

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“…Mulders et al, found a sensitivity of 53.3% and a specificity of 87.9% for the UA PI in antenatal prediction of neonatal mortality. 19 However slightly lower sensitivity and specificity was obtained in this study. The sensitivity and specificity of the umbilical artery PI in predicting adverse foetal outcome were 50% and 59% according to a study published by Lakhar et al 20 In this study, 30 of 100 patients showed abnormal and 70 patients showed normal CPR values.…”

Section: Discussioncontrasting

confidence: 63%

Comparative performance of Cerebral Perfusion Ratio as compared to MCA PI and UA PI in prediction of adverse perinatal outcomes in intra uterine growth restricted fetuses

et al. 2019

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Background: Intra uterine growth restriction (IUGR) is a common clinical sign seen due to chronic foetal hypoxemia and is considered a major contributor of perinatal morbidity and mortality. The aim of the present study was to determine and compare the sensitivity and specificity of umbilical artery pulsatility index (UA PI), middle cerebral artery (MCA) PI and cerebral perfusion ratio (CPR) in predicting adverse and poor perinatal outcomes in fetuses with IUGR.Methods: The study included 100 pregnant women with post 24 weeks of gestation with clinical history of IUGR. Doppler examination parameters, including waveforms and measurements, of the umbilical artery, middle cerebral artery were recorded. The Cerebral Perfusion Ratio (CPR) was calculated from MCA PI and UA PI and a final comparison of accuracy of Doppler indices was done with perinatal outcome.Results: The sensitivity of the UA PI was higher (49.3%) than that of the MCA PI (43.6%) and the CPR (37.7%). The specificity of the CPR was higher (87.1%) than that of the MCA PI (83.9%) and the UA PI (74.2%).Conclusions: From the findings of the study, it can be concluded that UA PI is the most sensitive and CPR is the most specific parameter in predicting adverse perinatal outcomes in IUGR fetuses. Thus, in addition to pulsatility indices, CPR should be used as a tool for surveillance and included in the routine reporting formats of obstetric Doppler studies.

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A comparative study of three indices of umbilical blood flow in relation to prediction of growth retardation

Cited by 27 publications

References 12 publications

Comparison of Diagnostic Efficacy of Umbilical Artery and Middle Cerebral Artery Waveform with Color Doppler Study for Detection of Intrauterine Growth Restriction

Comparison of Diagnostic Efficacy of Umbilical Artery and Middle Cerebral Artery Waveform with Color Doppler Study for Detection of Intrauterine Growth Restriction

Precision of umbilical artery Doppler studies. Intraobserver, interobserver, and biologic variability of fetal Doppler velocimetry.

Comparative performance of Cerebral Perfusion Ratio as compared to MCA PI and UA PI in prediction of adverse perinatal outcomes in intra uterine growth restricted fetuses

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