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Evaluation of third trimester uterine artery flow velocity indices in relationship to perinatal complications.

Ghosh, Gisela LU ; Breborowicz, A ; Brazert, M ; Maczkiewicz, M ; Kobelski, M ; Dubiel, M and Gudmundsson, Saemundur LU (2006) In Journal of Maternal-Fetal & Neonatal Medicine 19(9). p.551-555
Abstract
Objective. Uterine artery Doppler is becoming a routine part of pregnancy surveillance in high-risk pregnancies. Which blood flow velocity waveform index to measure is debated and the 'notch' in early diastole is not widely accepted, as it is a subjective measure. The aim of the present study was to evaluate the different indices in the prediction of adverse outcome of pregnancies suspected for intrauterine fetal growth restriction (IUGR). Methods. Uterine artery blood flow was recorded in 217 pregnancies admitted for Doppler ultrasound surveillance due to suspected IUGR. The median gestational age at examination was 38 weeks (range 25-42 weeks). Only cases having bilateral uterine artery notching were included in the evaluation. The... (More)
Objective. Uterine artery Doppler is becoming a routine part of pregnancy surveillance in high-risk pregnancies. Which blood flow velocity waveform index to measure is debated and the 'notch' in early diastole is not widely accepted, as it is a subjective measure. The aim of the present study was to evaluate the different indices in the prediction of adverse outcome of pregnancies suspected for intrauterine fetal growth restriction (IUGR). Methods. Uterine artery blood flow was recorded in 217 pregnancies admitted for Doppler ultrasound surveillance due to suspected IUGR. The median gestational age at examination was 38 weeks (range 25-42 weeks). Only cases having bilateral uterine artery notching were included in the evaluation. The uterine artery Doppler spectrum was analyzed for different indices, including evaluation of notch and end-diastolic velocities. Umbilical artery Doppler velocimetry was also performed. The outcome variables chosen were: a small-for-gestational-age (SGA) newborn, preterm birth, and abdominal delivery. ROC-curve calculations were used to compare the different indices. Results. The uterine artery blood velocity pulsatility index (PI) and resistance indices (RI) were the best predictors of adverse outcome of pregnancy. Apart from premature birth, the systolic/end-diastolic ratio was less predictive of adverse outcome. The indices including only diastolic blood velocities were the least predictive of adverse outcome. The group with notch velocity above end-diastolic velocity was compared with those having notch velocity below the end-diastolic velocity. No difference in outcome was seen between the two groups. Conclusions. RI and PI as measures of third trimester utero-placental vascular impedance are the best predictors of adverse outcome of IUGR-suspected pregnancies. (Less)
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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
impedance, vascular, Doppler, growth restriction, pregnancy, uterine artery, notch
in
Journal of Maternal-Fetal & Neonatal Medicine
volume
19
issue
9
pages
551 - 555
publisher
Taylor & Francis
external identifiers
  • wos:000240875400005
  • scopus:33748528924
ISSN
1476-7058
DOI
10.1080/14767050600852510
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Pediatrics/Urology/Gynecology/Endocrinology (013240400)
id
344e403a-47e6-4fba-bf7e-5ab87f64c3f6 (old id 161056)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16966123&dopt=Abstract
date added to LUP
2016-04-01 11:38:53
date last changed
2021-05-19 03:34:23
@article{344e403a-47e6-4fba-bf7e-5ab87f64c3f6,
  abstract     = {Objective. Uterine artery Doppler is becoming a routine part of pregnancy surveillance in high-risk pregnancies. Which blood flow velocity waveform index to measure is debated and the 'notch' in early diastole is not widely accepted, as it is a subjective measure. The aim of the present study was to evaluate the different indices in the prediction of adverse outcome of pregnancies suspected for intrauterine fetal growth restriction (IUGR). Methods. Uterine artery blood flow was recorded in 217 pregnancies admitted for Doppler ultrasound surveillance due to suspected IUGR. The median gestational age at examination was 38 weeks (range 25-42 weeks). Only cases having bilateral uterine artery notching were included in the evaluation. The uterine artery Doppler spectrum was analyzed for different indices, including evaluation of notch and end-diastolic velocities. Umbilical artery Doppler velocimetry was also performed. The outcome variables chosen were: a small-for-gestational-age (SGA) newborn, preterm birth, and abdominal delivery. ROC-curve calculations were used to compare the different indices. Results. The uterine artery blood velocity pulsatility index (PI) and resistance indices (RI) were the best predictors of adverse outcome of pregnancy. Apart from premature birth, the systolic/end-diastolic ratio was less predictive of adverse outcome. The indices including only diastolic blood velocities were the least predictive of adverse outcome. The group with notch velocity above end-diastolic velocity was compared with those having notch velocity below the end-diastolic velocity. No difference in outcome was seen between the two groups. Conclusions. RI and PI as measures of third trimester utero-placental vascular impedance are the best predictors of adverse outcome of IUGR-suspected pregnancies.},
  author       = {Ghosh, Gisela and Breborowicz, A and Brazert, M and Maczkiewicz, M and Kobelski, M and Dubiel, M and Gudmundsson, Saemundur},
  issn         = {1476-7058},
  language     = {eng},
  number       = {9},
  pages        = {551--555},
  publisher    = {Taylor & Francis},
  series       = {Journal of Maternal-Fetal & Neonatal Medicine},
  title        = {Evaluation of third trimester uterine artery flow velocity indices in relationship to perinatal complications.},
  url          = {http://dx.doi.org/10.1080/14767050600852510},
  doi          = {10.1080/14767050600852510},
  volume       = {19},
  year         = {2006},
}