P05.27: Abnormal end-diastolic flow pattern in the umbilical artery and perinatal mortality

Background: Umbilical artery Doppler blood flow studies were a better predictor of neonatal outcome than estimated fetal weight alone in intrauterine growth restricted (IUGR) fetuses. Perinatal mortality and morbidity are increased if the umbilical artery Doppler abnormality worsens.Methods: This study was conducted in Department of Obstetrics and Gynaecology, Thanjavur medical college from August 2015 to August 2016. One hundred singleton pregnancies complicated by IUGR beyond 32 weeks were subjected for Doppler study of umbilical artery. Perinatal outcome in terms of baby outcome, birth weight, early neonatal death, admission in NICU and duration of admission in NICU were analysed.Results: The main indication of termination of pregnancy was oligohydramnios (70%). The other causes of termination were 8% for uncontrolled hypertension and 4 % for post term. 60 % were delivered vaginally and 40% by lower segment cesarean section. Various indication for LSCS were Non-reactive CTG, fetal distress, severe oligohydramnios and failed induction. 92% were delivered alive babies and 8% still born babies. Birth weight of the babies varied from 900gm to 2.5Kg. But patients with absent or reversed end diastolic flow in umbilical artery Doppler, 80% of the babies weighed less than 1.5Kg. Perinatal mortality in our study is 19% which includes 8% of intrapartum mortality and 11% of neonatal mortality and perinatal morbidity is 24%. When the diastolic flow in the umbilical artery is, absent or reversed, it is associated with increased perinatal mortality of 80%.Conclusions: The results of present study clearly demonstrated the efficacy of umbilical artery Doppler in predicting the fetal outcome. To improve the predictive value of this tool, a better method is needed to assess the wellbeing of the IUGR fetuses such as integrated antenatal test which combines BPP and Doppler study employing other vessels.

Download Full-text

P05.26: Prognostic factors for survival in fetuses with reverse end-diastolic flow on Doppler umbilical artery velocimetry

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.1428 ◽

2004 ◽

Vol 24 (3) ◽

pp. 302-302

Author(s):

S. Lanz ◽

A. Cromi ◽

F. Ghezzi ◽

E. Di Naro ◽

V. Bergamini ◽

...

Keyword(s):

Prognostic Factors ◽

Umbilical Artery ◽

Diastolic Flow

Download Full-text

Umbilical artery Doppler changes in fetal growth restriction with intermittently absent umbilical artery end-diastolic flow

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2021.11.648 ◽

2022 ◽

Vol 226 (1) ◽

pp. S386-S387

Author(s):

Eileen Xu ◽

Nandini Raghuraman ◽

Katherine H. Bligard ◽

Jeffrey Dicke ◽

Anthony O. Odibo ◽

...

Keyword(s):

Fetal Growth ◽

Fetal Growth Restriction ◽

Umbilical Artery ◽

Growth Restriction ◽

Diastolic Flow ◽

Umbilical Artery Doppler

Download Full-text

Explanation of Perinatal Mortality Rate in Collaborative Study

PEDIATRICS ◽

10.1542/peds.52.6.891 ◽

1973 ◽

Vol 52 (6) ◽

pp. 891-891

Author(s):

Arnold S. Goldstein ◽

Henry H. Mangurten

Keyword(s):

Mortality Rate ◽

Perinatal Mortality ◽

Umbilical Artery ◽

Collaborative Study ◽

The United States ◽

Mortality Rates ◽

Single Umbilical Artery ◽

Neonatal Deaths ◽

General Mortality ◽

Future Management

The article by Froehlich and Fujikura1 on the prognosis of single umbilical artery is a much needed and highly informative addition to the literature. It presents a great deal of information and some important implications as to future management. We question the mortality rates quoted. They are given as percentages, and include stillbirths and neonatal deaths, i.e., perinatal mortality. The figure given as the general mortality rate is 3.8% or 38 per 1,000 births. Previous figures cited for perinatal mortality in the United States have varied from approximately 19 per 1,000 to approximately 26 per 1,000.2-4 We wonder how the figure of 38 per 1,000 was determined.

Download Full-text

Doppler ultrasound of umbilical artery in prediction of fetal outcome in pregnancy induced hypertension Sudanese population

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195890 ◽

2019 ◽

Vol 8 (1) ◽

pp. 96

Author(s):

Rihab A. Yousif ◽

Awadia G. Suliman ◽

Raga A. Aburaida ◽

Ibrahim M. Daoud ◽

Naglaa E. Mohammed

Keyword(s):

Flow Velocity ◽

Umbilical Artery ◽

Fetal Outcome ◽

Fetal Mortality ◽

Pregnancy Induced Hypertension ◽

Diastolic Flow ◽

Induced Hypertension ◽

The Mean ◽

Doppler Indices ◽

In Pregnancy

The pregnancy induced hypertension increase the fetal mortality and morbidity and the using of Doppler umbilical artery indices decrease the fetal mortality and morbidity however, there is few complete data about the most frequently altered Doppler US parameters to predict fetal outcome in pregnancy induced hypertension . Methods This ia cohort prospective study done in two hundred and six women of second and third trimester presenting to antenatal clinic in Soba University Hospital at the department of Obstetrics & Gynecology, in the fetus unit and critical pregnancy in the period From June 2008 to April 2013 to assess the Doppler indices of umbilical artery in pregnancy induced hypertension for prediction of prenatal outcome; 105 pregnancy induced hypertension patients and 101 women with uneventful pregnancies as normal control group included in this study . Baseline investigations and color Doppler of umbilical artery were done. Statistical analysis of data were done using SPSS, Receiver Operating Characteristic (ROC) curve analysis was performed and the area under the curve (AUC) used to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of umbilical artery Doppler indices to predict fetal outcome.Results The study determine that there was significant difference in Doppler indices in PIH and control group ( p<0.01, the mean indices of umbilical artery is higher in PIH group compared with normal pregnancy group , the mean different of S/D ratio was 0.40, mean difference of RI was 0.06 and the mean different of PI index was 0.16, high percentage of adverse fetal outcome had been reported in in Pregnancy Induced Hypertension group than in control , which was more in absent and reversed flow velocity in umbilical artery in Pregnancy Induced Hypertension compared with group of Pregnancy Induced Hypertension with present end diastolic flow velocity. Systolic/Diastolic ratio was most accurate in predicting adverse outcome in pregnancy induced hypertension patients, followed by the Pulastility index then the Resistance index (75%, 66% and 57% respectively).ConclusionThis study concluded that pregnancy induced hypertension leads to worsen placental insufficiently, which appears on the higher Doppler indices of umbilical artery to PIH patients when compared with normal pregnancy. A low diastolic flow and higher indices characterized the pregnancies with abnormal outcomes. Doppler of the umbilical artery was useful to predict fetal well being in PIH patients, high percentage of adverse fetal outcome had been reported in absent and reversed end diastolic flow velocity in umbilical artery compared with group of present flow velocity.

Download Full-text