Umbilical artery pulsatility index and fetal abdominal circumference in isolated gastroschisis

Objective: To examine the umbilical arterial Doppler flow patterns in late third-trimester fetuses with trisomy 21. Methods: This is a retrospective study on fetuses with trisomy 21 that were evaluated after 33 weeks' gestation at the Department of Obstetrics and Gynaecology of the University of Tuebingen, Germany. The umbilical and the middle cerebral artery (UA and ACM) pulsatility index (PI) measurements and the abdominal circumference were transformed into z-values. Results: Forty-two fetuses met the study criteria. The mean gestational age at the time of the first and the second visit was 35.0 and 36.6 weeks, respectively. The mean UA PI was 1.31 and 1.38, which corresponds to z-values of 2.20 and 2.70. In 24 (57.1%) cases, both PI measurements were above the 95th centile. A linear regression analysis demonstrated that the mean of both UA PI was not dependent on the abdominal circumference or on any other examined maternal and pregnancy characteristics. The mean ACM PI at the first and the second visit was 1.62 and 1.48, respectively, corresponding to mean z-values of -0.59 and -0.75, and in none of the cases was it below the 5th centile. Conclusion: In half of the third-trimester fetuses with trisomy 21, the resistance in the UA is increased - even in the absence of placental insufficiency.

Download Full-text

Defining the relationship between fetal Doppler indices, abdominal circumference and growth rate in severe fetal growth restriction using functional linear discriminant analysis

Journal of The Royal Society Interface ◽

10.1098/rsif.2013.0376 ◽

2013 ◽

Vol 10 (88) ◽

pp. 20130376 ◽

Cited By ~ 8

Author(s):

Alon Talmor ◽

Anneleen Daemen ◽

Edile Murdoch ◽

Hannah Missfelder-Lobos ◽

Dirk Timmerman ◽

...

Keyword(s):

Growth Rate ◽

Fetal Growth ◽

Fetal Growth Restriction ◽

Pulsatility Index ◽

Umbilical Artery ◽

Growth Restriction ◽

Abdominal Circumference ◽

Ductus Venosus ◽

Linear Discriminant ◽

The Relationship

The relationship between Doppler measurements, size and growth rate in fetal growth restriction has not been defined. We used functional linear discriminant analysis (FLDA) to investigate these parameters taking account of the difficulties inherent in exploring relationships between repeated observations from a small number of cases. In 40 fetuses with severe growth restriction, serial abdominal circumference (AC), umbilical, middle cerebral artery (MCA) and ductus venosus Doppler pulsatility index measurements were recorded. In 11 singleton fetuses with normal growth, umbilical artery pulsatility index only was measured. Data were expressed as z -scores in relation to gestation and analysed longitudinally using FLDA. In severe growth restriction, the Spearman correlation coefficients between umbilical artery pulsatility index and AC z -score, MCA pulsatility index and AC z -score and ductus venosus pulsatility index z -score and AC z -score were, respectively: −0.36, p = 4.4 × 10 −7 ; 0.70, p = 1.1 × 10 −17 and −0.50, p = 8.1 × 10 −4 . No relationship was seen between Doppler parameters and growth rate. There was no relationship between umbilical artery pulsatility index and AC nor growth rate in normally grown fetuses. In severe fetal growth restriction, Doppler changes are related to absolute fetal AC size, not growth rate.

Download Full-text

684 Intertwin differences in umbilical artery pulsatility index and risk for twin-to-twin transfusion syndrome

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2020.12.708 ◽

2021 ◽

Vol 224 (2) ◽

pp. S429-S430

Author(s):

Jimmy Espinoza ◽

Ozhan Turan ◽

Andres F. Espinoza ◽

Elizabeth Kravitz ◽

Summer Walton ◽

...

Keyword(s):

Pulsatility Index ◽

Umbilical Artery

Download Full-text

Umbilical artery pulsatility index in early pregnancies with chromosome anomalies

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.1996.tb09737.x ◽

1996 ◽

Vol 103 (4) ◽

pp. 330-334 ◽

Cited By ~ 21

Author(s):

J. M. Martinez ◽

C. Comas ◽

J. Ojuel ◽

B. Puerto ◽

A. Borrell ◽

...

Keyword(s):

Pulsatility Index ◽

Umbilical Artery ◽

Chromosome Anomalies

Download Full-text

Abstract 11740: Fetal and Neonatal Markers of Neurodevelopmental Outcome in Congenital Heart Disease

Circulation ◽

10.1161/circ.130.suppl_2.11740 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ismee A Williams ◽

Howard Andrews ◽

Michael M Myers ◽

William Fifer

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Infant Development ◽

Umbilical Artery ◽

Neurodevelopmental Outcome ◽

Abdominal Circumference ◽

Temporal Region ◽

Z Score ◽

The Right

Objectives: Children with congenital heart disease (CHD) are at risk for abnormal neurodevelopment (ND). We evaluated associations between fetal Doppler and biometry measures, neonatal electroencephalogram (EEG) and 18-month ND. Methods: Fetuses with hypoplastic left heart syndrome (HLHS), transposition of the great arteries (TGA), and tetralogy of Fallot (TOF) had middle cerebral (MCA) and umbilical artery (UA) Doppler velocities, as well as biometry such as head (HC) and abdominal circumference (AC), prospectively recorded at 20-25 (F1), 26-32 (F2), and 33-39 (F3) wks gestational age (GA). Pulsatility indices (PI) with GA-derived z-scores and cerebral-to-placental resistance (CPR) ratios were calculated. Neonatal high-density EEG was preformed preoperatively and the Bayley Scales of Infant Development-III were assessed at 18-months. Factor analysis was used to reduce the number of EEG predictors used in regression analysis. Results: Among 56 CHD fetuses (N=19 HLHS, N=16 TGA, N=21 TOF) who underwent preoperative EEG, ND scores are available for 33 to date. Cardiac subtype was highly associated with EEG and was considered in all models. Cognition scores were predicted by CPR< 1 ever (B=-15.7, P=0.002) and HC/AC at F2 (B=-130, P=0.013, R 2 =0.42). Language scores were predicted by UA PI z-score at F1 (B=-9.6, P=0.005, R 2 =0.27). Motor scores were predicted by UA PI z-score at F1 (B=-3.9, P=0.085), HLHS (B=-15, P<0.001), EFW%ile (B=0.374, P=0.007), and delta band right parietal and right temporal log power in active sleep (B=3.9, P=0.045, R 2 =0.61). Conclusion: Lower umbilical artery pulsatility at 20-25 wks GA was associated with higher 18-month Language and Motor scores. A diagnosis of HLHS predicted poorer Motor scores. Increased EEG power in the parietal and temporal region of the right brain predicted higher Motor scores. A larger abdomen relative to head at 26-32 wks was associated with improved cognition while diminished cerebrovascular compared with placental resistance predicted poorer cognition, similar to what has been observed in the growth restricted fetus. Further investigation is needed to confirm these hypothesis-generating findings.

Download Full-text

Intertwin differences in umbilical artery pulsatility index are associated with infant survival in twin-to-twin transfusion syndrome

Journal of Perinatal Medicine ◽

10.1515/jpm-2021-0060 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Jimmy Espinoza ◽

Michael A. Belfort ◽

Alireza A. Shamshirsaz ◽

Ahmed A. Nassr ◽

Magdalena Sanz Cortes ◽

...

Keyword(s):

Laser Surgery ◽

Pulsatility Index ◽

Umbilical Artery ◽

Curve Analysis ◽

Receiver Operating Characteristics ◽

Regression Analyses ◽

Infant Survival ◽

Operating Characteristics ◽

Roc Curve Analysis ◽

Double Twin

Abstract Objectives To evaluate the association of intertwin differences in umbilical artery pulsatility index (DUAPI) and infant survival in twin-to-twin transfusion syndrome (TTTS). Methods Absolute DUAPI was calculated prior to laser surgery. Receiver-operating characteristics (ROC) curve analysis provided an intertwin DUAPI cutoff of 0.4 for the prediction of double twin survival to 30 days of life. Infant survival was compared between women with an intertwin DUAPI <0.4 and ≥0.4 in the whole cohort, in TTTS cases with Quintero stages I/II and in those with Quintero stages III/IV. Regression analyses were performed to evaluate the association of intertwin DUAPI <0.4 and infant survival adjusted for confounders. Results In total, 349 TTTS cases were included. Double twin survival to 30 days was observed in 67% (234/349) of cases. Significant differences in double twin survival was seen between intertwin DUAPI groups in the whole cohort (76.8 vs. 52.2%; p<0.001), in women with TTTS Quintero stage I or II (77.8 vs. 58.5%; p=0.015) as well as in women with TTTS Quintero stage III or IV (75 vs. 49.5%; p=0.001). Intertwin DUAPI <0.4 conferred a threefold increased chance for double twin survival. Conclusions Small intertwin DUAPI is associated with increased double infant survival in early and advanced TTTS stages.

Download Full-text