Screening for fetal well-being in a high-risk pregnant population comparing the nonstress test with umbilical artery doppler velocimetry: A randomized controlled clinical trial

Williams, Keith Philip; Farquharson, Duncan F.; Bebbington, Michael; Dansereau, Jerome; Galerneau, France; Wilson, R. Douglas; Shaw, Dorothy; Kent, Nancy

doi:10.1067/mob.2003.305

Cited by 85 publications

(36 citation statements)

References 16 publications

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“…Doppler assessment of the umbilical artery is used to gauge placental resistance, and is standardly performed in fetuses with growth restriction. Williams et al [50] randomized 1,360 patients from a high-risk pregnant population (11% of whom were diabetic) to NST versus umbilical artery Doppler, both performed twice a week, and showed that the incidence of cesarean delivery for fetal distress was significantly lower in the Doppler group than the NST group (4.6% vs 8.7%), without an increase in neonatal morbidity. There was one stillbirth in the NST group.…”

Section: Assessment Of Fetal Well-beingmentioning

confidence: 97%

Sonographic Evaluation and the Pregnancy Complicated by Diabetes

McNamara

Odibo

2010

Curr Diab Rep

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Sonography is a fundamental tool in the management of pregnancies affected by maternal diabetes. Purposeful use of ultrasound in each trimester provides an invaluable amount of information about the developing fetus including gestational age and growth patterns, anatomical structure and function, assessment of fetal well-being, and prediction of adverse outcome. There are great ongoing research efforts in this field of prenatal diagnosis and management, yet even more are needed.

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Section: Assessment Of Fetal Well-beingmentioning

confidence: 97%

Sonographic Evaluation and the Pregnancy Complicated by Diabetes

McNamara

Odibo

2010

Curr Diab Rep

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“…Por sua vez, o feto desacelera seu ritmo de crescimento, reduz a movimentação, faz uso de mecanismos compensatórios pela centralização da sua circulação frente à hipóxia crônica. A elevação anormal dos índices doplervelocimétricos da artéria umbilical precede as alterações da FCF e do PBF 51,52 . Apesar da grande heterogeneidade, estudos aleatorizados controlados em gestações de alto risco demonstram a eficiência da doplervelocimetria da artéria umbilical em melhorar os resultados perinatais [53][54][55][56][57] .…”

Section: Artéria Umbilicalunclassified

Avaliação da vitalidade fetal anteparto

Nomura¹,

Miyadahira²,

Zugaib³

2009

Rev. Bras. Ginecol. Obstet.

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RevisãoResumo O contexto atual da atividade médica exige do obstetra e ginecologista ampla compreensão dos avanços científicos e tecnológicos de sua área. O objetivo primordial da avaliação fetal antenatal é identificar fetos de risco para eventos adversos ou para o óbito e, assim, atuar preventivamente para evitar o insucesso. O perfil biofísico fetal atinge sua máxima eficiência quando aplicado dentro do contexto clínico de cada caso. Em gestações de alto risco, a doplervelocimetria da artéria umbilical mostrou-se útil para melhorar os resultados perinatais. Na restrição de crescimento fetal por insuficiência placentária grave, antes da 34ª semana de gestação, a doplervelocimetria do ducto venoso tem sido importante instrumento na condução dos casos. Nenhum teste isoladamente é considerado o melhor na avaliação da vitalidade fetal anteparto, entretanto, a análise conjunta de todos os métodos irá propiciar melhor compreensão da resposta fetal à hipóxia. AbstractThe present context of medical practice demands from the obstetrician and gynecologist broad understanding of the scientific and technological advances of the area. The main purpose of prenatal evaluation is to identify fetuses at risk for adverse events or death, for preventive action to avoid mishappenings. The determination of fetal biophysical profile reaches its maximum efficiency when applied within the clinical context of each case. In high risk gestations, the Doppler velocimetry of the umbilical artery has shown to be useful to improve perinatal outcome. In the fetal growth deficit, due to severe placentary insufficiency, Doppler velocimetry of the venous duct has been showing to be an important tool in handling of the cases before the 34 th week of gestation. Although no test itself is considered the best to evaluate the fetus's prenatal vitality, the joint analysis of all methods may lead to a better understanding of the fetal response to hypoxia.

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“…There is also limited evidence of randomized, clinical trials that support daily practice modalities that can be used for assessment of fetal wellbeing during the antenatal and intrapartum periods. The only testing modality for which there is Level 1 evidence is the use of umbilical artery Doppler for fetal surveillance in growth restricted fetuses [3].…”

Section: Introductionmentioning

confidence: 99%

Pulsed Umbilical Artery Doppler Ultrasound Findings in Management of High-Risk Term Pregnant Women during Labour

Hamid¹,

Alalaf²,

Al-Tawil³

2017

OJOG

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Purpose: Intrapartum Doppler velocimetry is a non-invasive investigation method. This method is useful for evaluating the pathophysiological mechanisms underlying changes in fetal heart rate. This study aimed to determine the usefulness of Doppler ultrasound findings during labor in high-risk women on determining the mode of delivery and outcome of the newborn. Methods: A cross-sectional study was conducted from January 1, 2015 to December 31, 2015 on 100 high-risk pregnant women during labor. The study was performed in the Maternity Teaching Hospital in Erbil City, Kurdistan Region, Iraq. Results: The majority of women (77%) had a normal end-diastolic blood flow pattern through the umbilical artery. A total of 76.9% of those with abnormal Doppler results had a Cesarean delivery compared with only 9.5% of those with normal Doppler results (p < 0.001). The rate of early neonatal death was significantly higher (15.4%) in women with abnormal Doppler results than in those with normal Doppler results (1.4%, p = 0. 016). Admission to the neonatal intensive care unit was significantly more frequent in women with abnormal Doppler results than in those with normal Doppler results (61.5% vs. 17.6, p < 0.001). The same pattern was seen in the Apgar score in the first (p = 0.07) and fifth minutes (p = 0.01). Conclusions: Abnormal umbilical artery Doppler ultrasound findings in highrisk pregnancies for women in labor are associated with increased rates of emergency cesarean sections and a poor outcome of the newborn.

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Screening for fetal well-being in a high-risk pregnant population comparing the nonstress test with umbilical artery doppler velocimetry: A randomized controlled clinical trial

Cited by 85 publications

References 16 publications

Sonographic Evaluation and the Pregnancy Complicated by Diabetes

Sonographic Evaluation and the Pregnancy Complicated by Diabetes

Avaliação da vitalidade fetal anteparto

Pulsed Umbilical Artery Doppler Ultrasound Findings in Management of High-Risk Term Pregnant Women during Labour

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