Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction
(2023) In Ultraschall in der Medizin 44(1). p.56-67- Abstract
Purpose To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). Materials and Methods A prospective European multicenter observational study included women with a singleton pregnancy, 32 +0-36 +6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] <10 th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of >40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (<0.9) or abnormal (≥0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear... (More)
Purpose To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). Materials and Methods A prospective European multicenter observational study included women with a singleton pregnancy, 32 +0-36 +6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] <10 th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of >40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (<0.9) or abnormal (≥0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements. Results 856 women had 2770 measurements; 696 (81%) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7%) a UCR ≥0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30% vs. 9%, relative risk 3.2; 95%CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67% (95%CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6% (95%CI 5-7%). The risk of composite adverse outcome was similar using the first or subsequent UCR values. Conclusion An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7% when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.
(Less)
- author
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- adverse outcome, brain sparing, Doppler, late fetal growth restriction, middle cerebral artery
- in
- Ultraschall in der Medizin
- volume
- 44
- issue
- 1
- pages
- 56 - 67
- publisher
- Georg Thieme Verlag
- external identifiers
-
- pmid:34768305
- scopus:85119856683
- ISSN
- 0172-4614
- DOI
- 10.1055/a-1511-8293
- language
- English
- LU publication?
- yes
- id
- ebb46afd-cc2a-41d0-9be2-4ad7432d7669
- date added to LUP
- 2021-12-14 15:27:16
- date last changed
- 2024-06-15 22:42:15
@article{ebb46afd-cc2a-41d0-9be2-4ad7432d7669,
abstract = {{<p>Purpose To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). Materials and Methods A prospective European multicenter observational study included women with a singleton pregnancy, 32 +0-36 +6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] <10 th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of >40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (<0.9) or abnormal (≥0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements. Results 856 women had 2770 measurements; 696 (81%) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7%) a UCR ≥0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30% vs. 9%, relative risk 3.2; 95%CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67% (95%CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6% (95%CI 5-7%). The risk of composite adverse outcome was similar using the first or subsequent UCR values. Conclusion An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7% when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR. </p>}},
author = {{Mylrea-Foley, Bronacha and Wolf, Hans and Stampalija, Tamara and Lees, Christoph and Arabin, B. and Berger, A. and Bergman, E. and Bhide, A. and Bilardo, C. M. and Breeze, A. C. and Brodszki, J. and Calda, P. and Cetin, I. and Cesari, E. and Derks, J. and Ebbing, C. and Ferrazzi, E. and Ganzevoort, W. and Frusca, T. and Gordijn, S. J. and Gyselaers, W. and Hecher, K. and Klaritsch, P. and Krofta, L. and Lindgren, P. and Lobmaier, S. M. and Marlow, N. and Maruotti, G. M. and Mecacci, F. and Myklestad, K. and Napolitano, R. and Prefumo, F. and Raio, L. and Richter, J. and Sande, R. K. and Thornton, J. and Valensise, H. and Visser, G. H.A. and Wee, L.}},
issn = {{0172-4614}},
keywords = {{adverse outcome; brain sparing; Doppler; late fetal growth restriction; middle cerebral artery}},
language = {{eng}},
number = {{1}},
pages = {{56--67}},
publisher = {{Georg Thieme Verlag}},
series = {{Ultraschall in der Medizin}},
title = {{Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction}},
url = {{http://dx.doi.org/10.1055/a-1511-8293}},
doi = {{10.1055/a-1511-8293}},
volume = {{44}},
year = {{2023}},
}