OBJECTIVE: To evaluate the changes in myocardial performance index (MPI) and aortic isthmus (AoI) and ductus venosus (DV) Doppler in term, small-for-gestational age (SGA) fetuses with normal umbilical artery (UA) Doppler. METHODS: MPI, AoI and DV pulsatility indices (PI) were measured within 1 week prior to delivery in a cohort of 178 term singleton consecutive SGA fetuses with normal UA-PI (< 95(th) percentile) and 178 controls matched by gestational age. Cardiovascular parameters were converted into Z-scores and values above the 95(th) centile defined as abnormal. RESULTS: Median gestational age at inclusion and at delivery was 35.7 and 38.6 weeks, respectively. Compared to controls, SGA fetuses showed significantly higher values in MPI and AoI-PI and similar values in DV-PI. SGA fetuses showed a significantly higher proportion of increased MPI (28.1 vs. 6.7%; P < 0.01) and abnormal AoI-PI (14.6 vs. 5.1%; P < 0.01) than controls. The proportion of cases with abnormal DV-PI was similar between SGA cases and controls. Retrograde net blood flow in the AoI was observed in 7.3% of the SGA cases and in none of the controls. CONCLUSION: A proportion of SGA fetuses show cardiovascular Doppler abnormalities. This information might be of clinical relevance in improving the detection and management of late-onset intrauterine growth restriction.
OBJECTIVE: To evaluate the changes in myocardial performance index (MPI) and aortic isthmus (AoI) and ductus venosus (DV) Doppler in term, small-for-gestational age (SGA) fetuses with normal umbilical artery (UA) Doppler. METHODS: MPI, AoI and DV pulsatility indices (PI) were measured within 1 week prior to delivery in a cohort of 178 term singleton consecutive SGA fetuses with normal UA-PI (< 95(th) percentile) and 178 controls matched by gestational age. Cardiovascular parameters were converted into Z-scores and values above the 95(th) centile defined as abnormal. RESULTS: Median gestational age at inclusion and at delivery was 35.7 and 38.6 weeks, respectively. Compared to controls, SGA fetuses showed significantly higher values in MPI and AoI-PI and similar values in DV-PI. SGA fetuses showed a significantly higher proportion of increased MPI (28.1 vs. 6.7%; P < 0.01) and abnormal AoI-PI (14.6 vs. 5.1%; P < 0.01) than controls. The proportion of cases with abnormal DV-PI was similar between SGA cases and controls. Retrograde net blood flow in the AoI was observed in 7.3% of the SGA cases and in none of the controls. CONCLUSION: A proportion of SGA fetuses show cardiovascular Doppler abnormalities. This information might be of clinical relevance in improving the detection and management of late-onset intrauterine growth restriction.
Authors: Ryan Hodges; Masayuki Endo; Andre La Gerche; Elisenda Eixarch; Philip DeKoninck; Vessilina Ferferieva; Jan D'hooge; Euan M Wallace; Jan Deprest Journal: J Vis Exp Date: 2013-06-29 Impact factor: 1.355
Authors: Neil Hamill; Roberto Romero; Sonia Hassan; Wesley Lee; Stephen A Myers; Pooja Mittal; Juan Pedro Kusanovic; Mamtha Balasubramaniam; Tinnakorn Chaiworapongsa; Edi Vaisbuch; Jimmy Espinoza; Francesca Gotsch; Luis F Goncalves; Shali Mazaki-Tovi; Offer Erez; Edgar Hernandez-Andrade; Lami Yeo Journal: Am J Obstet Gynecol Date: 2012-12-07 Impact factor: 8.661