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Placental pulsatility index : a new, more sensitive parameter for predicting adverse outcome in pregnancies suspected of fetal growth restriction

Gudmundsson, Saemundur LU ; Flo, Kari; Ghosh, Gisela LU ; Wilsgaard, Tom and Acharya, Ganesh (2017) In Acta Obstetricia et Gynecologica Scandinavica 96(2). p.216-222
Abstract

Introduction: The pulsatility indices of the umbilical and uterine arteries are used as the surrogate measures of utero-placental perfusion. Combining the two might simplify the evaluation of total placental vascular impedance, possibly improve prediction of adverse outcomes, and help identify pregnancies with suspected fetal growth restriction that need more intense surveillance. Material and methods: Umbilical and uterine blood flow velocities were recorded using pulsed-wave Doppler in a longitudinal study of 53 low-risk pregnancies (248 observations) during 20–40 weeks of gestation. Pulsatility indices was calculated for each of these vessels. A new placental pulsatility index was constructed as: (umbilical artery pulsatility index +... (More)

Introduction: The pulsatility indices of the umbilical and uterine arteries are used as the surrogate measures of utero-placental perfusion. Combining the two might simplify the evaluation of total placental vascular impedance, possibly improve prediction of adverse outcomes, and help identify pregnancies with suspected fetal growth restriction that need more intense surveillance. Material and methods: Umbilical and uterine blood flow velocities were recorded using pulsed-wave Doppler in a longitudinal study of 53 low-risk pregnancies (248 observations) during 20–40 weeks of gestation. Pulsatility indices was calculated for each of these vessels. A new placental pulsatility index was constructed as: (umbilical artery pulsatility index + mean of the left and right uterine artery pulsatility indices)/2, and mean +2 SD defined as abnormal. Gestational age-specific reference percentiles were calculated for the second half of pregnancy and related to values obtained from 340 pregnancies with suspected intra-uterine growth restriction to test its ability to predict adverse pregnancy outcome. Results: The placental pulsatility index was closely associated with gestational age and decreased with advancing gestation in normal pregnancy. The placental pulsatility index had a higher sensitivity and comparable specificity in predicting adverse outcome in pregnancies suspected of intra-uterine fetal growth restriction when compared with conventional umbilical and uterine artery pulsatility indices. Conclusions: The new placental pulsatility index, reflecting placental vascular impedance on both the fetal and maternal side of placenta, improves prediction of adverse outcome in pregnancies suspected of intra-uterine fetal growth restriction.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Doppler, fetal growth restriction, Placenta pulsatility index, pregnancy, small for gestational age, umbilical artery, uterine artery
in
Acta Obstetricia et Gynecologica Scandinavica
volume
96
issue
2
pages
7 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85010917043
  • wos:000393615900012
ISSN
0001-6349
DOI
10.1111/aogs.13060
language
English
LU publication?
yes
id
4cc1ea45-0b6c-45b1-b609-db15ab1a8400
date added to LUP
2017-02-14 12:23:13
date last changed
2018-04-22 04:26:23
@article{4cc1ea45-0b6c-45b1-b609-db15ab1a8400,
  abstract     = {<p>Introduction: The pulsatility indices of the umbilical and uterine arteries are used as the surrogate measures of utero-placental perfusion. Combining the two might simplify the evaluation of total placental vascular impedance, possibly improve prediction of adverse outcomes, and help identify pregnancies with suspected fetal growth restriction that need more intense surveillance. Material and methods: Umbilical and uterine blood flow velocities were recorded using pulsed-wave Doppler in a longitudinal study of 53 low-risk pregnancies (248 observations) during 20–40 weeks of gestation. Pulsatility indices was calculated for each of these vessels. A new placental pulsatility index was constructed as: (umbilical artery pulsatility index + mean of the left and right uterine artery pulsatility indices)/2, and mean +2 SD defined as abnormal. Gestational age-specific reference percentiles were calculated for the second half of pregnancy and related to values obtained from 340 pregnancies with suspected intra-uterine growth restriction to test its ability to predict adverse pregnancy outcome. Results: The placental pulsatility index was closely associated with gestational age and decreased with advancing gestation in normal pregnancy. The placental pulsatility index had a higher sensitivity and comparable specificity in predicting adverse outcome in pregnancies suspected of intra-uterine fetal growth restriction when compared with conventional umbilical and uterine artery pulsatility indices. Conclusions: The new placental pulsatility index, reflecting placental vascular impedance on both the fetal and maternal side of placenta, improves prediction of adverse outcome in pregnancies suspected of intra-uterine fetal growth restriction.</p>},
  author       = {Gudmundsson, Saemundur and Flo, Kari and Ghosh, Gisela and Wilsgaard, Tom and Acharya, Ganesh},
  issn         = {0001-6349},
  keyword      = {Doppler,fetal growth restriction,Placenta pulsatility index,pregnancy,small for gestational age,umbilical artery,uterine artery},
  language     = {eng},
  month        = {02},
  number       = {2},
  pages        = {216--222},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Placental pulsatility index : a new, more sensitive parameter for predicting adverse outcome in pregnancies suspected of fetal growth restriction},
  url          = {http://dx.doi.org/10.1111/aogs.13060},
  volume       = {96},
  year         = {2017},
}