Open AccessDuctus venosus Doppler waveform pattern in fetuses with early growth restriction
Author(s) -
Fratelli Nicola,
Amighetti Serena,
Bhide Amar,
Fichera Anna,
Khalil Asma,
Papageorghiou Aris T.,
Prefumo Federico,
Thilaganathan Basky
Publication year - 2020
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13782
Subject(s) - ductus venosus , medicine , gestational age , odds ratio , obstetrics , intrauterine growth restriction , umbilical artery , fetus , small for gestational age , population , cardiology , pregnancy , genetics , environmental health , biology
We aimed to assess if maximum velocities of the ductus venosus flow velocity waveform are associated with adverse outcomes in early‐onset fetal growth restriction. Material and methods Retrospective cohort study from two tertiary referral units, including singleton fetuses with estimated birthweight or fetal abdominal circumference ≤10th centile and absent or reversed end‐diastolic velocity in the umbilical artery delivered between 26 +0 and 34 +0 weeks of gestation. Pulsatility index for veins, and maximum velocities of S‐, D‐, v‐ and a‐waves, were measured in the ductus venosus within 24 hours of birth. Logistic regression was used to describe the relation between severe neonatal morbidity or neonatal death and clinical independent predictors. Results The study population included 132 early‐onset fetal growth restriction fetuses. Newborns with neonatal morbidity or neonatal death had significantly lower values of v/D maximum velocity ratio multiples of the median (0.86 vs 095; P = 0.006) within 24 hours of birth. The v/D ratio remained a significant predictor of neonatal death or severe neonatal morbidity after adjusting for gestational age and birthweight (adjusted odds ratio 0.065, 95% confidence interval 0.004‐0.957). Conclusions Assessment of ductus venosus v/D maximum velocity ratio might help to identify fetal growth restriction fetuses at increased risk for neonatal death or severe neonatal morbidity. Confirmation in prospective studies is necessary.