Significance of abnormal umbilical artery Doppler studies in normally grown fetuses

Abstract

Objective: To determine whether there is a relationship between abnormal umbilical artery Doppler studies (UADS) and small for gestational age (SGA) birth weight and other adverse perinatal outcomes in fetuses that appear normally grown by ultrasound. Methods: This was a retrospective study of all women who had UADS performed at or after 26 weeks of gestation at our institution between January 2005 and December 2012. Women were excluded if they had a fetal demise, a fetus with growth restriction, a fetus with congenital anomaly, or a multiple gestation. Women with missing delivery outcomes were excluded. The primary outcome was birth weight below the 10th percentile. Results: There were 2744 women included in the study. Of those, 98 (3.6%) had an abnormal UADS, and 379 (13.8%) had an SGA neonate. Of the 2646 women who had a normal UADS, 353 (13.3%) women had an SGA neonate. Twentysix (26.5%) of the 98 women who had an abnormal UADS had an SGA neonate. After adjusting for potential confounders, the adjusted odds ratio for an SGA neonate with an abnormal UADS was 2.2 (95% CI, 1.38-3.58; p < 0.05). In examining other adverse perinatal outcomes, neonatal intensive care unit (NICU) admission and low 5-min Apgar scores were 12.4 and 2.3%, respectively. The adjusted odds ratio for NICU admission was 1.84 (95% CI, 1.06-3.21; p < 0.05). Abnormal UADS was not associated with low Apgar scores (aOR 1.39: 95% CI 0.47-4.07; p > 0.05). Conclusions:Our data suggest that abnormal UADS in fetuses that appear normally grown by ultrasound are associated with SGA neonates and NICU admission.

Ultrasonographic findings of the corpus luteum and the gravid uterus during heat stress in dairy cattle

“…In humans, umbilical artery Doppler examination is widely used for the evaluation of the foetal haemodynamic state and it is considered as a valuable examination for monitoring growth restricted foetuses and for the prediction of perinatal outcomes (De Paco et al., 2014; Maulik et al., 2010; Turan et al., 2008). The haemodynamic parameters that characterize the blood flow in umbilical artery are PI, RI and SV/DV; PI reflects peripheral resistance, RI reflects the vascular elasticity and SV/DV reflects the impedance of the placenta (Al Hamayel et al., 2020). Changes in these parameters demonstrate high‐risk pregnancy (Li et al., 2014).…”

Middle cerebral arterial flow redistribution is an indicator for intrauterine fetal compromise in late pregnancy in low‐resource settings: A prospective cohort study

“…Some studies, mostly from HICs, show significant correlations between abnormal umbilical and middle cerebral artery Doppler measurements and perinatal complications in fetuses that appear appropriately grown upon ultrasound 10–15 . This suggests a potential role for Doppler ultrasound in preventing stillbirths among women with low‐risk pregnancies or undergoing routine ANC.…”

“…9 Some studies, mostly from HICs, show significant correlations between abnormal umbilical and middle cerebral artery Doppler measurements and perinatal complications in fetuses that appear appropriately grown upon ultrasound. [10][11][12][13][14][15] This suggests a potential role for Doppler ultrasound in preventing stillbirths among women with low-risk pregnancies or undergoing routine ANC. Although its effectiveness as a screening tool has not been established in these HIC settings, it is clear that test performance depends on the underlying prevalence of perinatal complications or abnormal Doppler in the general population.…”

Doppler Ultrasound of the Umbilical Artery: Clinical Application

“…When compared with PEDV, AREDV fetuses have a higher incidence of low birthweight, worse Apgar scores, and oligohydramnios; greater number of labor inductions and caesarean sections due to fetal distress; admissions to neonatal intensive care unit; fetal demise; perinatal mortality and morbidity, 58 59 60 61 62 as well as long-term neurological impairment. 14 63 64 65 The lower the gestational age and fetal weight at birth, the more severe are the neonatal complications.…”