Normogram of umbilical artery Doppler indices in singleton pregnancies in south‐western Nigerian women

Ayoola, Oluwagbemiga Oluwole; Bulus, Peter; Loto, Olabisi M.; Idowu, Bukunmi Michael

doi:10.1111/jog.13114

Cited by 16 publications

(22 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The highest prevalence was reported by Yoon et al, who reported a prevalence of AEDF or REDF of 2.13% amongst 328 unselected-risk women in South Korea [38]. The four studies (898 women) conducted in lower middle-income countries (Bangladesh, Papua New Guinea, Nigeria and Tunisia) did not report any cases of AEDF or REDF [39][40][41][42]. Similarly, a three-country prospective cohort study of 431 healthy, low-risk women by Drukker et al in Brazil, Kenya and the UK identified no AEDF cases in any country [29].…”

Section: Resultsmentioning

confidence: 92%

Prevalence of abnormal umbilical arterial flow on Doppler ultrasound in low-risk and unselected pregnant women: a systematic review

et al. 2021

View full text Add to dashboard Cite

Background While Doppler ultrasound screening is beneficial for women with high-risk pregnancies, there is insufficient evidence on its benefits and harms in low- and unselected-risk pregnancies. This may be related to fewer events of abnormal Doppler flow, however the prevalence of absent or reversed end diastolic flow (AEDF or REDF) in such women is unknown. In this systematic review, we aimed to synthesise available data on the prevalence of AEDF or REDF. Methods We searched PubMed, Embase, CINAHL, CENTRAL and Global Index Medicus with no date, setting or language restrictions. All randomized or non-randomized studies reporting AEDF or REDF prevalence based on Doppler assessment of umbilical arterial flow > 20 weeks’ gestation were eligible. Two authors assessed eligibility and extracted data on primary (AEDF and REDF) and secondary (fetal, perinatal, and neonatal mortality, caesarean section) outcomes, with results presented descriptively. Results A total of 42 studies (18,282 women) were included. Thirty-six studies reported zero AEDF or REDF cases. However, 55 AEDF or REDF cases were identified from just six studies (prevalence 0.08% to 2.13%). Four of these studies were in unselected-risk women and five were conducted in high-income countries. There was limited evidence from low- and middle-income countries. Conclusions Evidence from largely observational studies in higher-income countries suggests that AEDF and REDF are rare among low- and unselected-risk pregnant women. There are insufficient data from lower-income countries and further research is required.

show abstract

Section: Resultsmentioning

confidence: 92%

Prevalence of abnormal umbilical arterial flow on Doppler ultrasound in low-risk and unselected pregnant women: a systematic review

et al. 2021

View full text Add to dashboard Cite

show abstract

“…We found only five articles presenting reference ranges for CPR. Table 1 describes the main characteristics and number of citations of the 19 selected studies [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] .…”

Section: Resultsmentioning

confidence: 99%

“…We found important sources of bias in the most widely used studies 18 ; ultrasound examinations were not performed for research purposes 24,25,28,30,33,34,40 , neither the recruitment period 24,25,[27][28][29]31,32,34,38 nor perinatal results 24 were described, or the study was performed at a single center [24][25][26][27][28][29][30][31]37,39 . We also found a lack of reporting of necessary sample sizes 24,26,[28][29][30][31][34][35][36]38,40 , gestational-age dating method [25][26][27][28]31,40 , experience of the sonographers 24,[26][27][28]…”

Section: This Is the First Systematic Review To Analyze The Impact Ofmentioning

confidence: 99%

Clinical impact of Doppler reference charts on management of small‐for‐gestational‐age fetuses: need for standardization

Ruiz

Papageorghiou

Staines-Urias

et al. 2020

Ultrasound in Obstet & Gyne

View full text Add to dashboard Cite

Objective To assess clinical variability in the management of small‐for‐gestational‐age (SGA) fetuses according to different published Doppler reference charts for umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler indices and cerebroplacental ratio (CPR). Methods We performed a systematic search of MEDLINE, EMBASE, CINAHL and the Web of Science databases from 1954 to 2018 for studies with the sole aim of creating fetal Doppler reference values for UA, MCA and CPR. The top cited articles for each Doppler parameter were included. Variability in Doppler values at the following clinically relevant cut‐offs was assessed: UA‐pulsatility index (PI) > 95th percentile; MCA‐PI < 5th percentile; and CPR < 5th percentile. Variability was calculated for each week of gestation and expressed as the percentage difference between the highest and lowest Doppler value at the clinically relevant cut‐offs. Simulation analysis was performed in a cohort of SGA fetuses (n = 617) to evaluate the impact of this variability on clinical management. Results From a total of 40 studies that met the inclusion criteria, 19 were analyzed (13 for UA‐PI, 10 for MCA‐PI and five for CPR). Wide discrepancies in reported Doppler reference values at clinically relevant cut‐offs were found. MCA‐PI showed the greatest variability, with differences of up to 51% in the 5th percentile value at term. Variability in the 95th percentile of UA‐PI and the 5th percentile of CPR at each gestational week ranged from 21% to 41% and 15% to 33%, respectively. As expected, on simulation analysis, these differences in Doppler cut‐off values were associated with significant variation in the clinical management of SGA fetuses, despite using the same protocol. Conclusions The choice of Doppler reference chart can result in significant variation in the clinical management of SGA fetuses, which may lead to suboptimal outcomes and inaccurate research conclusions. Therefore, an attempt to standardize fetal Doppler reference ranges is needed. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

show abstract

“…Although fixed reference points such as the fetal or placental end of the umbilical cord have been previously used for Doppler velocimetry, free‐floating loops of umbilical cord (as used in the present study) have remained popular due to the ease with which they can be identified 31 . In a previous study conducted at the current study institution with similar objectives, 32 a cross‐sectional methodology was used, whereby each fetus was sampled once without a rigorous technique of pregnancy dating. In addition, that study did not report the outcomes of the pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Normative references and clinical correlates of fetal umbilical artery Doppler indices in southwestern Nigeria

Awowole

Kuti

Asaleye

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To derive normative references for umbilical artery (UA) Doppler indices, including pulsatility index (PI), resistance index (RI), and systolic/diastolic (SD) ratio, for singleton pregnancies in Ile‐Ife, Nigeria, and compare them with reference values from other populations. Methods A longitudinal study involving 415 women with a singleton fetus at 26–40 gestational weeks attending Obafemi Awolowo University Hospital, Ile‐Ife, between July 2015 and March 2019. Fetal UA PI, RI, and SD ratio were measured every 4 weeks until delivery. Reference values from the 2.5th to the 97.5th centiles were derived from 1375 measurements. Correlations between indices and bio‐demographic characteristics were assessed; regression equations were generated. Results The RI, PI, and SD ratio decreased by 0.013, 0.027, and 0.71, respectively, for each additional week of pregnancy. There was a negative correlation between the three indices and birthweight (P<0.001), but not maternal parity, age, or fetal gender. Regression equations for RI, PI, and SD ratio were, respectively, 1.004 – 0.013x, 1.78 – 0.027x, and 4.77 – 0.71x, where x is gestational age (weeks). Conclusion The derived normative references for fetal UA Doppler indices are recommended for monitoring high‐risk pregnancies in Nigeria. The indices are comparable to those derived from Norwegian, Thai, and British cohorts.

show abstract

Normogram of umbilical artery Doppler indices in singleton pregnancies in south‐western Nigerian women

Abstract: A normogram of umbilical artery Doppler indices was constructed, which showed that the indices decreased with gestational age. These normative data could serve as reference ranges for evaluation of the umbilical artery circulation in this locality.

Cited by 16 publications

References 21 publications

Prevalence of abnormal umbilical arterial flow on Doppler ultrasound in low-risk and unselected pregnant women: a systematic review

Prevalence of abnormal umbilical arterial flow on Doppler ultrasound in low-risk and unselected pregnant women: a systematic review

Clinical impact of Doppler reference charts on management of small‐for‐gestational‐age fetuses: need for standardization

Normative references and clinical correlates of fetal umbilical artery Doppler indices in southwestern Nigeria

Contact Info

Product

Resources

About