OBJECTIVE: To assess from diagnosis to delivery the Doppler studies of the umbilical artery, middle cerebral artery, umbilical vein, ductus venosus, and amniotic fluid index of fetuses with idiopathic growth restriction. METHODS: A total of 145 singleton growth-restricted fetuses with abnormal umbilical artery pulsatility indexes were studied. Cesarean delivery was performed because of abnormal biophysical profile or nonreassuring fetal heart rate pattern. RESULTS: There were 4 fetal and 50 neonatal deaths. Two growth-restricted groups were identified: Group A (n = 44) included fetuses in whom all measures became abnormal preceding an abnormal biophysical profile or nonreassuring nonstress test. Group B (n = 101) included fetuses in whom 1 or more measures were normal at the time of cesarean delivery. There was no statistically significant difference in perinatal morbidity and mortality between the 2 groups. Neonatal death was increased in fetuses with umbilical artery reversed flow (odds ratio 2.34, 95% confidence interval 1.16-4.73; P < .05) and ductus venosus reversed flow (odds ratio 4.18, 95% confidence interval 2.01-8.69; P < .05). A significant correlation was also found between low birth weight and adverse perinatal outcome. CONCLUSION: In fetuses with idiopathic growth restriction, 1) low birth weight, 2) umbilical artery reversed flow, and 3) ductus venosus absent or reversed flow are associated with an increased perinatal morbidity and mortality.
OBJECTIVE: To assess from diagnosis to delivery the Doppler studies of the umbilical artery, middle cerebral artery, umbilical vein, ductus venosus, and amniotic fluid index of fetuses with idiopathic growth restriction. METHODS: A total of 145 singleton growth-restricted fetuses with abnormal umbilical artery pulsatility indexes were studied. Cesarean delivery was performed because of abnormal biophysical profile or nonreassuring fetal heart rate pattern. RESULTS: There were 4 fetal and 50 neonatal deaths. Two growth-restricted groups were identified: Group A (n = 44) included fetuses in whom all measures became abnormal preceding an abnormal biophysical profile or nonreassuring nonstress test. Group B (n = 101) included fetuses in whom 1 or more measures were normal at the time of cesarean delivery. There was no statistically significant difference in perinatal morbidity and mortality between the 2 groups. Neonatal death was increased in fetuses with umbilical artery reversed flow (odds ratio 2.34, 95% confidence interval 1.16-4.73; P < .05) and ductus venosus reversed flow (odds ratio 4.18, 95% confidence interval 2.01-8.69; P < .05). A significant correlation was also found between low birth weight and adverse perinatal outcome. CONCLUSION: In fetuses with idiopathic growth restriction, 1) low birth weight, 2) umbilical artery reversed flow, and 3) ductus venosus absent or reversed flow are associated with an increased perinatal morbidity and mortality.
Authors: Nir Melamed; Ahmet Baschat; Yoav Yinon; Apostolos Athanasiadis; Federico Mecacci; Francesc Figueras; Vincenzo Berghella; Amala Nazareth; Muna Tahlak; H David McIntyre; Fabrício Da Silva Costa; Anne B Kihara; Eran Hadar; Fionnuala McAuliffe; Mark Hanson; Ronald C Ma; Rachel Gooden; Eyal Sheiner; Anil Kapur; Hema Divakar; Diogo Ayres-de-Campos; Liran Hiersch; Liona C Poon; John Kingdom; Roberto Romero; Moshe Hod Journal: Int J Gynaecol Obstet Date: 2021-03 Impact factor: 3.561
Authors: Atul Malhotra; Michael Ditchfield; Michael C Fahey; Margie Castillo-Melendez; Beth J Allison; Graeme R Polglase; Euan M Wallace; Ryan Hodges; Graham Jenkin; Suzanne L Miller Journal: Pediatr Res Date: 2017-05-17 Impact factor: 3.756
Authors: N Giuliano; M L Annunziata; S Tagliaferri; F G Esposito; O C M Imperato; M Campanile; M G Signorini; A Di Lieto Journal: J Pregnancy Date: 2014-12-09
Authors: Andrea Dall'Asta; Valentina Brunelli; Federico Prefumo; Tiziana Frusca; Christoph C Lees Journal: Matern Health Neonatol Perinatol Date: 2017-01-18