Comparative efficacy of umbilical arterial Doppler indices for predicting adverse perinatal outcome

Maulik, Dev; Yarlagadda, Prasad; Youngblood, James P.; Ciston, Pamela

doi:10.1016/0002-9378(91)91421-r

Cited by 36 publications

(6 citation statements)

References 14 publications

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“…Doppler velocimetry can be used to monitor redistribution patterns of blood flow in the pregnancy with IUGR, suggesting a risk for further fetal compromise [ 15 , 17 , 34 ]. However, besides assessment of the umbilical artery in the third trimester of pregnancy, Doppler measurements of various other vessels are suggested in guidelines, without specification of thresholds [ 10 – 13 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands

Verfaille

Jonge

Mokkink

et al. 2017

BMC Pregnancy Childbirth

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BackgroundScreening for, diagnosis and management of intrauterine growth restriction (IUGR) is often performed in multidisciplinary collaboration. However, variation in screening methods, diagnosis and management of IUGR may lead to confusion. In the Netherlands two monodisciplinary guidelines on IUGR do not fully align. To facilitate effective collaboration between different professionals in perinatal care, we undertook a Delphi study with uniform recommendations as our primary result, focusing on issues that are not aligned or for which specifications are lacking in the current guidelines.MethodsWe conducted a Delphi study in three rounds. A purposively sampled selection of 56 panellists participated: 27 representing midwife-led care and 29 obstetrician-led care. Consensus was defined as agreement between the professional groups on the same answer and among at least 70% of the panellists within groups.ResultsPer round 51 or 52 (91% - 93%) panellists responded. This has led to consensus on 27 issues, leading to four consensus based recommendations on screening for IUGR in midwife-led care and eight consensus based recommendations on diagnosis and eight on management in obstetrician-led care. The multidisciplinary project group decided on four additional recommendations as no consensus was reached by the panel. No recommendations could be made about induction of labour versus expectant monitoring, nor about the choice for a primary caesarean section.ConclusionsWe reached consensus on recommendations for care for IUGR within a multidisciplinary panel. These will be implemented in a study on the effectiveness and cost-effectiveness of routine third trimester ultrasound for monitoring fetal growth. Research is needed to evaluate the effects of implementation of these recommendations on perinatal outcomes.Trial registration NTR4367.

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Section: Discussionmentioning

confidence: 99%

Multidisciplinary consensus on screening for, diagnosis and management of fetal growth restriction in the Netherlands

Verfaille

Jonge

Mokkink

et al. 2017

BMC Pregnancy Childbirth

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“…Gestational age at delivery was determined from the date of the last menstrual period and was confirmed by first-trimester ultrasonography. Doppler flow velocity waveforms from the umbilical arteries were obtained within 24 h of birth and the resistance index was calculated [18].…”

Section: Methodsmentioning

confidence: 99%

Leptin: A Potential Marker of Placental Insufficiency

Lepercq

Guerre-Millo

André

et al. 2003

Gynecol Obstet Invest

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To investigate placental leptin production in placental insufficiency, placental leptin production was measured in women with severe preeclampsia (group 1) and in normotensive pregnancies associated with intrauterine growth restriction (group 2), compared to controls (group 3). Placental leptin content was increased 3-fold in group 1 compared to group 2 (192.5.1 ± 39.5 vs. 67.8 ± 10.6 ng/g) and 8-fold in group 1 compared to group 3 (192.5.1 ± 39.5 vs. 25.4 ± 6.9 ng/g). Placental leptin content was positively correlated with maternal leptin/BMI ratio (r = 0.62) and the resistance index of the umbilical artery (r = 0.60). These data demonstrate that placental insufficiency is associated with a dramatic increase in placental leptin production. This results in a rise in maternal leptinemia that may be taken as an early index of placental dysfunction.

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“…6) to investigate the comparative efficacy of the umbilical arterial Doppler indices for predicting adverse perinatal outcome and showed that the RI had the best discriminatory ability when compared with the S/D ratio (P<.05), the PI (P<.001), and the D/A ratio (P<.05). 16 The S/D ratio, however, remains the most popular index.…”

Section: Doppler Sonography Of the Umbilical Arterymentioning

confidence: 99%