Effect of Maternal and Fetal Characteristics in Feto-Placental Doppler and Impact of Using Adjusted Standards in the Definition of Fetal Growth Restriction at Term
Language English Country Switzerland Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial
PubMed
34515108
DOI
10.1159/000518093
PII: 000518093
Knihovny.cz E-resources
- Keywords
- Adjusted Doppler standards, Cerebroplacental ratio, Doppler standards, Fetal growth restriction, Small for gestational age, Umbilical artery Doppler,
- MeSH
- Middle Cerebral Artery diagnostic imaging MeSH
- Umbilical Arteries diagnostic imaging MeSH
- Gestational Age MeSH
- Infant, Small for Gestational Age MeSH
- Humans MeSH
- Infant, Newborn MeSH
- Placenta * diagnostic imaging MeSH
- Fetus MeSH
- Pulsatile Flow MeSH
- Retrospective Studies MeSH
- Fetal Growth Retardation * diagnostic imaging MeSH
- Pregnancy MeSH
- Ultrasonography, Doppler MeSH
- Ultrasonography, Prenatal MeSH
- Check Tag
- Humans MeSH
- Infant, Newborn MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
INTRODUCTION: This study aimed to determine the effect and clinical impact of physiological characteristics on the 95th/5th centile of the umbilical artery (UA) Doppler and the cerebroplacental ratio (CPR), at 36+ weeks. METHODS: From the multicenter randomized trial "Ratio37," we selected 4,505 low-risk pregnant women between June 2016 and January 2020. We registered physiological characteristics and the pulsatility indexes (PI) of the UA and middle cerebral artery (36-39 weeks). The 95th/5th centile of the UA PI and CPR was modeled by quantile regression. To evaluate the clinical impact of adjusting Doppler, we retrospectively applied gestational age (GA) and fully adjusted standards to 682 small for gestational age (SGA)-suspected fetuses (37 weeks) from a cohort of consecutive patients obtained between January 2010 and January 2020. RESULTS: Several physiological characteristics significantly influenced the 95th/5th centile of the UA and CPR PI. The fully adjusted 95th centile of the UA was higher, and the 5th centile of the CPR was lower than GA-only-adjusted standards. Of the 682 SGA fetuses, 150 (22%) were classified as late fetal growth restricted only by GA and 112 (16.4%) when we adjusted Doppler. These 38 fetuses had similar perinatal outcome than the SGA group. DISCUSSION: The 95th/5th centile of the UA and CPR PI is significantly influenced by physiological characteristics. Adjusting Doppler standards could differentiate better between FGR and SGA.
Department of Obstetrics and Gynecology Fetal Medicine Unit University of Chile Santiago Chile
Fetomaternal Medicine Department General Hospital Dr Eduardo Liceaga of Mexico City Mexico Mexico
Institute for the Care of Mother and Child Prague Prague Czechia
Obstetrics and Gynecology Consorci Parc de Salut Mar Hospital del Mar Barcelona Spain
Obstetrics and Gynecology Palacky University Olomouc Olomouc Czechia
Obstetrics and Gynecology Tel Aviv Sourasky Medical Centre Tel Aviv Israel
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