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Retraction: Doppler ultrasound of the uteroplacental circulation in the prediction of pregnancy outcome in women with raised maternal serum alpha‐fetoprotein
Author(s) -
Robson M.,
Hamid R.,
McParland P.,
Pearce J. M.
Publication year - 1994
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1994.tb13144.x
Subject(s) - medicine , obstetrics , placental abruption , placental circulation , pregnancy , fetal circulation , observational study , fetus , placenta , biology , genetics
Objective To determine whether Doppler waveforms from the uteroplacental circulation could improve the prediction of pregnancy outcome in women with raised maternal serum alpha‐fetoprotein and a structurally normal fetus. The study further attempts to determine whether the presence of an early diastolic notch would constitute a better screening test than waveform patterns. Design An observational study. Setting A tertiary referral obstetric service. Subjects All women referred to St George's Hospital with a raised maternal serum alpha‐fetoprotein had waveform measurements from the uteroplacental circulation after exclusion of fetal abnormalities. Pregnancy outcome was determined by questionnaire sent to the referring clinicians. Main outcome measures Adverse perinatal outcome in the form of preterm labour, low birthweight and perinatal mortality. Results Data from 332 cases were available for analysis. Women with a normal pattern of uteroplacental waveforms had a perinatal mortality of 9.6/1000. Women with a uniform high resistance pattern had a perinatal mortality of 846/1000, and those with a mixed resistance pattern had a perinatal mortality of 268/1000. Overall there were 27 cases of placental abruption which accounted for eight of the 50 perinatal deaths. The remainder were due to prematurity or low birthweight or both. The presence of the early diastolic notch did not improve on the waveform patterns in the prediction of perinatal death. Conclusion Women with raised maternal serum alpha‐fetoprotein and normal Doppler waveform patterns from the uteroplacental circulation can be reassured, but mixed or uniform high resistance patterns should encourage increased surveillance and a search for intervention therapies.