Fetal aortic isthmus Doppler measurements for prediction of perinatal morbidity and mortality associated with fetal growth restriction

2013 ◽  
Vol 92 (6) ◽  
pp. 656-661 ◽  
Author(s):  
Khalil Abdelrazzaq ◽  
Ahmet Özgür Yeniel ◽  
Ahmet Mete Ergenoglu ◽  
Nuri Yildirim ◽  
Fuat Akercan ◽  
...  
2019 ◽  
Vol 47 (2) ◽  
pp. 212-217
Author(s):  
Cecilia Villalaín ◽  
Ignacio Herraiz ◽  
Maria S. Quezada ◽  
Paula I. Gómez-Arriaga ◽  
Elisa Simón ◽  
...  

AbstractBackgroundAs conflicting results have been reported about the association of reversed flow on the aortic isthmus (AoI) and adverse perinatal results in fetal growth restriction (FGR), we aim to compare perinatal outcomes (including tolerance to labor induction) of late-onset FGR between those with anterograde and reversed AoI flow.MethodsThis was an observational retrospective cohort study on 148 singleton gestations diagnosed with late-onset FGR (diagnosis ≥32+0 weeks), with an estimated fetal weight (EFW) <10thcentile and mild fetal Doppler alteration: umbilical artery (UA) pulsatility index (PI) >95thcentile, middle cerebral artery (MCA)-PI <5thcentile or cerebral-placental ratio <5thcentile. Anterograde AoI flow was present in n=79 and reversed AoI flow in n=69. Delivery was recommended from 37 weeks in both groups. Perinatal results were compared between the groups.ResultsThe global percentage of vaginal delivery of fetuses with anterograde and reversed blood flow was 55.7% vs. 66.7% (P=0.18) and the percentage of cesarean section (C-section) for non-reassuring fetal status was 12.7% vs. 15.9% (P=0.29), respectively. When evaluating those that underwent labor induction, the vaginal delivery rate was 67.9% vs. 77.2% (P=0.17), respectively. There were no significant differences regarding any other perinatal variables and there were no cases of severe morbidity or mortality.ConclusionWe observed that the presence of reversed AoI flow does not worsen perinatal outcomes on fetuses with late-onset growth restriction with mild Doppler alterations. Attempt of labor induction is feasible in these fetuses regardless of the direction of AoI flow.


Author(s):  
Nathan R. Blue ◽  
Matthew Hoffman ◽  
Amanda A. Allshouse ◽  
William A. Grobman ◽  
Hyagriv N. Simhan ◽  
...  

Objective Our objective was to test the association of fetal adrenal size with perinatal morbidity among fetuses with fetal growth restriction (FGR; estimated fetal weight [EFW] < 10th percentile). Study Design This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) adrenal study, which measured fetal adrenal gland size at 22 to 30 weeks' gestation. We analyzed the transverse adrenal area (TAA) and fetal zone area (absolute measurements and corrected for fetal size) and the ratio of the fetal zone area to the total transverse area using a composite perinatal outcome of stillbirth, neonatal intensive care unit admission, respiratory distress syndrome, necrotizing enterocolitis, retinopathy of prematurity, sepsis, mechanical ventilation, seizure, or death. Among fetuses with FGR, adrenal measurements were compared between those that did and did not experience the composite perinatal outcome. Results There were 1,709 eligible neonates. Seven percent (n = 120) were diagnosed with FGR at the time of adrenal measurement, and 14.7% (n = 251) experienced perinatal morbidity. EFW-corrected and absolute adrenal measurements were similar among fetuses with and without FGR as well as among those who did and did not experience morbidity. The area under the curve for corrected TAA was 0.52 (95% confidence interval 0.38–0.67). Conclusion In our cohort, adrenal size was not associated with risk of morbidity among fetuses with FGR.


2010 ◽  
Vol 30 (5) ◽  
pp. 395-401 ◽  
Author(s):  
M. M. Kennelly ◽  
N. Farah ◽  
M. J. Turner ◽  
B. Stuart

1995 ◽  
Vol 7 (4) ◽  
pp. 207-233 ◽  
Author(s):  
Moshe Mazor ◽  
José Cohen ◽  
Roberto Romero ◽  
Fabio Ghezzi ◽  
Jorge E Tolosa ◽  
...  

Preterm labour and its consequences are the major contributors to perinatal morbidity and mortality worldwide. The prevention of preterm labour and delivery is the single most important challenge to modern obstetrics today. Progress in this area has been hampered by lack of understanding of the basic mechanisms responsible for preterm labour. The implicit paradigm which has governed the study of parturition, is that term and preterm labour are fundamentally the same processes except for the gestational age at which they occur. Indeed, they share a common terminal pathway composed of uterine contractility, cervical dilatation and rupture of membranes. We proposed that while term labour is the result of physiological activation of this common terminal pathway, preterm labour and delivery is the consequence of pathological activation.1Thus, preterm labour may be considered as the response of the fetomaternal unit to a variety of insults (e.g. chorioamnionitis, ischaemia, fetal growth restriction, etc.) (Fig 1) If these insults cannot be effectively handled in the context of a continuing pregnancy, then labour and delivery may occur.


2021 ◽  
Vol 2 (2) ◽  
pp. 85-94
Author(s):  
Andrea Dall’Asta ◽  
Monica Minopoli ◽  
Tullio Ghi ◽  
Tiziana Frusca

Early fetal growth restriction (FGR) remains a challenging entity associated with an increased risk of perinatal morbidity and mortality as well as maternal complications. Significant variations in clinical practice have historically characterized the management of early FGR fetuses. Nevertheless, insights into diagnosis and management options have more recently emerged. The aim of this review is to summarize the available evidence on monitoring, delivery and outcome in early-onset FGR.


Author(s):  
Yakubova D.I.

Objective of the study: Comprehensive assessment of risk factors, the implementation of which leads to FGR with early and late manifestation. To evaluate the results of the first prenatal screening: PAPP-A, B-hCG, made at 11-13 weeks. Materials and Methods: A retrospective study included 110 pregnant women. There were 48 pregnant women with early manifestation of fetal growth restriction, 62 pregnant women with late manifestation among them. Results of the study: The risk factors for the formation of the FGR are established. Statistically significant differences in the indicators between groups were not established in the analyses of structures of extragenital pathology. According to I prenatal screening, there were no statistical differences in levels (PAPP-A, b-hCG) in the early and late form of FGR.


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