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The pre‐eclampsia, growth restriction, and ductus venosus doppler ( GRADED ) study: An observational study of early‐onset fetal growth restriction and pre‐eclampsia
Author(s) -
Govender Vaeochan,
Naidoo Thinagrin D.,
Foolchand Serantha
Publication year - 2023
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.14495
Subject(s) - medicine , obstetrics , eclampsia , ductus venosus , placental abruption , odds ratio , intrauterine growth restriction , confidence interval , pregnancy , fetus , gynecology , biology , genetics
Objective To assess the feasibility of using ductus venosus Doppler (DVD) to time delivery in early‐onset fetal growth restriction (FGR) and pre‐eclampsia in a resource‐constrained setting. Methods This was a prospective, observational study of pregnancies affected by early‐onset FGR and pre‐eclampsia. Patient characteristics, risk factors, ultrasound findings, and pregnancy outcomes were entered into a data collection tool. The association of these variables with perinatal and maternal outcomes were determined using binary logistic regression analysis. Results The study had 61 participants. Most patients were delivered at 29–31 +6 weeks of pregnancy (67%). Neonates with an estimated fetal weight on ultrasound of less than 800 g had the highest incidence of perinatal mortality (63%). There was a near six‐fold increase in risk of major neonatal morbidity in patients with abnormal DVD (odds ratio 5.9, 95% confidence interval [CI] 1.8–19.0). Absent flow in the DVD a‐wave carried a higher risk of perinatal mortality (OR 23.8, 95% CI 1.7–334.8); 22% of patients with an abnormal DVD a‐wave experienced placental abruption. Conclusion Having an abnormal DVD in the background of pre‐eclampsia was related to increased perinatal morbidity and mortality, with increased risk of placental abruption.