Umbilical Artery Doppler Study as a Predictive Marker of Perinatal Outcome in Preterm Small for Gestational Age Infants

Abstract

PurposeTo evaluate the merit of umbilical artery Doppler study as a predictive marker of perinatal outcome in preterm small for gestational age (SGA) infants.Materials and MethodsA total of 218 patients at 27 - 36 weeks of gestational age (GA) who received antenatal umbilical artery Doppler velocimetry and delivered singleton infants with SGA. The ratio of peak-systolic to end-diastolic blood flow velocities (S/D) in the umbilical artery was measured in each patient. The patients were divided into 3 groups: the normal group with S/D ratios of less than 95th percentile (n = 134), elevated S/D ratio group of 95th or more percentile (n = 41), and those with absent/reversed end diastolic flow (n = 43). Maternal characteristics and neonatal outcomes of these groups were comparatively analyzed.ResultsThe gestational age (GA) at the time of diagnosis of SGA, the mean GA at delivery, and the mean birth weight showed statistically significant difference among three groups (p < 0.001). Also, poor perinatal outcome was significantly increased in infants with abnormal S/D ratio (13.4% vs. 31.7% vs. 67.4%, p < 0.001). Multivariate logistic regression analysis revealed umbilical artery Doppler study as a significant independent factor for prediction of poor perinatal outcome (odds ratio: 3.7, 95% confidence interval 1.4 - 9.5, p = 0.007).ConclusionAntenatal umbilical artery Doppler velocimetry is shown as a significantly efficient marker in predicting perinatal outcome in preterm SGA infants.

Correlation between Doppler and Perinatal Outcome in IUGR Babies

“…And we could see that IUGR with normal Doppler in umbilical artery is a benign condition 6 , and almost all of these babies had an uneventful perinatal outcome .Brain sparing effect was associated with higher perinatal complications in our study. In another study by Bacchantetal 7 Neonatal nucleated red blood cell counts in growth-restricted fetuses: relationship to arterial and venous Doppler and nucleated red cells and circulatory decompensation in IUGR were studied.…”

Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses

“…Doppler index increases and in the end, there appears absent/reversed end diastolic blood flow. 6,8,9 In IUGR fetuses there exists strict correlation between the umbilical artery doppler waveform and increased incidence of perinatal complications and, particularly, absent/reversed end diastolic umbilical arterial blood flow has been shown to be associated with high perinatal mortality, long term impairment of intellectual development, and neurodevelopmental delay. 6,10,11,12 detecting the fetus with pathological growth restriction that is at risk for perinatal complications has been an on going challenge in obstetrics.…”

“…4,5 Small for gestational age (SGE) occurs in approximately 5-10% of all pregnancies. 6 The primary cause in 60% of pregnancies with fetal growth restriction (FGR) has been reported to be placental insufficiency. 6,7 Inadequate invasion or non-invasion of the trophoblastic tissue within chorionic villi vessels leads to reduction in umbilical artery blood flow.…”

“…6 The primary cause in 60% of pregnancies with fetal growth restriction (FGR) has been reported to be placental insufficiency. 6,7 Inadequate invasion or non-invasion of the trophoblastic tissue within chorionic villi vessels leads to reduction in umbilical artery blood flow. Doppler index increases and in the end, there appears absent/reversed end diastolic blood flow.…”

The relation of pulsatility indices of middle cerebral, umbilical and uterine arteries with birth weight in normal pregnancies

“…The evaluation of umbilical artery Doppler indices in high risk pregnancy has been associated with reduction in perinatal deaths [12]. Prenatal umbilical artery Doppler evaluation is an effective marker in predicting poor perinatal outcome in IUGR fetuses [13].…”