scholarly journals Significance of umbilical artery doppler velocimetry in the perinatal outcome of growth restricted fetuses

2018 ◽  
Vol 7 (3) ◽  
pp. 1074
Author(s):  
Jyothi Susan Thomas ◽  
A. Malliga ◽  
S. Sethurajan
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Significant Rise ◽  
Growth Restriction ◽  
Doppler Velocimetry ◽  
Perinatal Complications ◽  
Chi Square ◽  
Chi Square Test ◽  
Umbilical Artery Doppler

Background: The objectives of the study are to determine the relationship between the umbilical artery Doppler and perinatal outcome in growth restricted foetuses and to compare the outcome with those of normal foetuses.Methods: A prospective observational study in which subjects were divided into two groups, pregnancies affected with intrauterine growth restriction (IUGR) and pregnancies with normal fetuses. Both the groups were followed with Doppler velocimetry of umbilical artery after 28 weeks till delivery. The perinatal outcome of both the groups with normal and abnormal umbilical artery Doppler (reduced/ absent/ reversed end – diastolic flow) were analysed with Chi-square test and student t - test using SPSS software version 15.0.Results: Umbilical artery Doppler velocimetry showed significant abnormality in growth restricted foetuses in comparison to normal foetuses. There was significant increase in the delivery of IUGR foetuses <37 weeks gestation(p<0.05). There was a significant increase in operative deliveries in both the groups with abnormal umbilical artery Doppler. A significant rise in adverse perinatal outcomes, Apgar <7 at 5 min and low birth weight in IUGR foetuses in comparison to normal foetuses (p<0.05).Conclusions: There is a strict correlation between abnormal umbilical artery Doppler velocimetry and an increased incidence of perinatal complications in growth restricted foetuses compared to normal foetuses. Hence, umbilical artery Doppler velocimetry should be used in all patients with fetal growth restriction, to identify impending hypoxia, to optimise the time of delivery and to optimise the perinatal outcome in these patients.

Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins

2011 ◽  
Vol 14 (5) ◽  
pp. 457-462 ◽  
Author(s):  
Boaz Weisz ◽  
Liat Hogen ◽  
Yoav Yinon ◽  
Liat Gindes ◽  
Alon Shrim ◽  
...  
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Perinatal Outcomes ◽  
Monochorionic Twins ◽  
Group A ◽  
Umbilical Artery Doppler ◽  
Group B ◽  
A Prospective Study ◽  
Gestational Age At Birth ◽  
Twin Pregnancies

Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.

Placental histopathological correlates of umbilical artery Doppler velocimetry in pregnancies complicated by fetal growth restriction

2012 ◽  
Vol 32 (13) ◽  
pp. 1263-1272 ◽  
Author(s):  
Arsenio Spinillo ◽  
Barbara Gardella ◽  
Silvia Bariselli ◽  
Alessandro Alfei ◽  
Enrico Silini ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Doppler Velocimetry ◽  
Umbilical Artery Doppler

scholarly journals Study of perinatal outcome of foetuses with nuchal cord

2018 ◽  
Vol 7 (9) ◽  
pp. 3507
Author(s):  
Misbah M. Inamdar ◽  
Asmita N. Patil
Keyword(s):  
Perinatal Outcome ◽  
Demographic Data ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Common Finding ◽  
Chi Square ◽  
Cross Sectional ◽  
Nuchal Cord ◽  
Chi Square Test ◽  
Meconium Staining

Background: Entanglement of the umbilical cord around the foetal neck (nuchal cord) is a common finding at delivery, but its clinical relevance is not entirely clear. Nuchal cords have generally been considered to be rather benign. However, the insufficiency in data regarding the role of nuchal cord in foetal morbidity and mortality is a source of anxiety and frustration to both parturient and healthcare professionals. Considering the above facts the present study was taken up to establish the incidence of nuchal cord at delivery in the existing setup.Methods: This was a cross sectional comparative study conducted over a period of one year from May 2013 to April 2014. A total of 362 women were selected for the study. These women were briefed about the nature of the study and a written informed consent was obtained. The demographic data and obstetrical history were documented on predesigned proforma. The data obtained was analysed using percentages and comparison done using chi-square test for discrete variables.Results: Incidence of Nuchal Cord was 17.7% among study cases. Based on this study gestational age may have an effect on the presence of nuchal cord (p<0.05). Out of 64 cases with nuchal cord’, 11.4% of cases had meconium stained liquor present. 9.8% of cases with nuchal cord had FHR irregularity, which was significantly less as compared to 20.0% of cases who did not show FHR irregularity. This was statistically significant. (p=0.032). 18.7% of mother who showed presence of nuchal cord had delivery by caesarean section. 22.7% of cases with nuchal cord had NICU admissions, which was insignificantly more as compared to 17.0% of cases who did not have NICU admissions.Conclusions: Intrapartum events such as meconium staining of liquor and foetal heart rate irregularities were more commonly associated with nuchal cord but it did not affect the perinatal outcome. However, the mode of delivery was independent of the presence of nuchal cord, thereby reducing the morbidity to the mother. Hence nuchal cord is not associated with adverse perinatal outcomes and the presence of a nuchal cord per se is not found to be an indication of operative delivery.

scholarly journals Interartery discordance in fetuses with growth restriction

2018 ◽  
Vol 8 (1) ◽  
pp. 42-47
Author(s):  
A. Dhanya Mackeen ◽  
John W. Ross ◽  
Alexandria Betz ◽  
Wen Feng ◽  
Jay J. Bringman ◽  
...  
Keyword(s):  
Observational Study ◽  
Clinical Outcomes ◽  
Prospective Observational Study ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Doppler Velocimetry ◽  
Umbilical Artery Doppler ◽  
The Individual ◽  
Umbilical Arteries ◽  
The Impact

Abstract OBJECTIVES: Our objectives were two-fold: 1) to determine the frequency of discordant umbilical artery Doppler systolic to diastolic (S/D) ratios in the individual umbilical arteries of growth-restricted fetuses and 2) to examine the impact of the frequency of discordance on clinical outcomes. METHODS: This was a prospective, observational study of growth-restricted fetuses. Doppler velocimetry was performed weekly and two S/D ratios were obtained for each fetal umbilical artery. Inter-artery discordance was defined as a difference in measurement categories (i.e., normal, elevated, absent, reversed) between the arteries. The number of abnormal measurements per visit was summed to 0-4 out of 4 values. A composite average number of abnormal Doppler measurements was calculated and fetuses were stratified based on degree of average number of abnormalities in increments of 25%: 0-<25%, 25-<50%, 50-<75%, and 75-100% abnormality. RESULTS: Of a total 241 fetuses (1762 visits), 110 (45.6%) had abnormal UAD flow and 189 (66%) demonstrated discordance. Abnormal values were noted in only one artery in 53% (n=151) of visits. Fetuses with any abnormal Doppler testing had smaller birthweights compared to fetuses with consistently normal testing (2485g vs 2623g, p <0.01); birthweight decreased as composite average of abnormal measurements increased (p = 0.03). CONCLUSION: The majority (66%) of fetuses with abnormal testing demonstrated UAD discordance. Up to 53% of fetuses could have been misdiagnosed if only one artery was tested. Fetuses with a higher frequency of Doppler abnormalities had lower birthweights. We propose obtaining two measurements from each umbilical artery in growth-restricted fetuses.

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