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Umbilical artery Doppler flow velocimetry in intrauterine growth restriction and its relation to perinatal outcome
Author(s) -
Seyam Y.S.,
AlMahmeid M.S.,
AlTamimi H.K.
Publication year - 2002
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 - 10.1016/s0020-7292(02)00027-9
Subject(s) - medicine , umbilical artery , oligohydramnios , velocimetry , laser doppler velocimetry , obstetrics , intrauterine growth restriction , gestational age , fetus , biophysical profile , cardiotocography , birth weight , pregnancy , cardiology , blood flow , genetics , physics , optics , biology
Objective: The purpose of this retrospective analysis was to compare pregnancy outcomes in growth‐restricted fetuses retaining normal umbilical artery Doppler flow and the outcomes of pregnancies with end‐diastolic velocity either diminished or severely reduced/absent. Methods: One hundred pregnant women with growth‐restricted fetuses were followed with Doppler velocimetry of the umbilical artery between weeks 28 and 41 of pregnancy. Outcomes were compared for the normal Doppler group (16%), the less‐severely abnormal group (77%), and the group with severely reduced or absent end‐diastolic velocity waveforms (7%). Results: The diagnosis‐to‐delivery interval was significantly shorter, and the average birth weight and gestational age at delivery were significantly lower, for fetuses with abnormal Doppler velocimetry (showing diminished or severely reduced/absent end‐diastolic velocity) than for those in the normal Doppler group. Fetuses with abnormal Doppler velocimetry also had a significantly higher incidence of oligohydramnios, low‐birth weight (<10th percentile), and admission to the Neonatal Intensive Care Unit. There were no perinatal deaths among the normal Doppler patients. Conclusions: Growth‐restricted fetuses with normal umbilical artery velocimetry are at significantly lower risk than those with abnormal velocity waveforms, and immediate delivery of the fetus with diminished end‐diastolic flow may be unnecessary. Knowing this relationship may be useful in the clinical management of such pregnancies. Doppler surveillance of growth‐restricted fetuses supplemented with cardiotocography, preferably combined with biophysical profile testing, results in a prolonged gestational age and acceptable fetal outcome.