Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction

Translated title of the contribution: Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction

Bronacha Mylrea-Foley, Hans Wolf, Tamara Stampalija, Christoph Lees, B. Arabin, A. Berger, E. Bergman, A. Bhide, C. M. Bilardo, A. C. Breeze, J. Brodszki, P. Calda, I. Cetin, E. Cesari, J. Derks, C. Ebbing, E. Ferrazzi, W. Ganzevoort, T. Frusca, S. J. GordijnW. Gyselaers, K. Hecher, P. Klaritsch, L. Krofta, P. Lindgren, S. M. Lobmaier, N. Marlow, G. M. Maruotti, F. Mecacci, K. Myklestad, R. Napolitano, F. Prefumo, L. Raio, J. Richter, R. K. Sande, J. Thornton, H. Valensise, G. H.A. Visser, L. Wee

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR). Materials and Methods A prospective European multicenter observational study included women with a singleton pregnancy, 32 +0-36 +6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] <10 thpercentile, abnormal arterial Doppler or fall in AC from 20-week scan of >40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (<0.9) or abnormal (≥0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements. Results 856 women had 2770 measurements; 696 (81%) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7%) a UCR ≥0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30% vs. 9%, relative risk 3.2; 95%CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67% (95%CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6% (95%CI 5-7%). The risk of composite adverse outcome was similar using the first or subsequent UCR values. Conclusion An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7% when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.

Translated title of the contributionLongitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction
Original languageEnglish
Pages (from-to)56-67
Number of pages12
JournalUltraschall in der Medizin (Stuttgart, Germany : 1980)
Volume44
Issue number1
DOIs
StatePublished - 7 Feb 2023
Externally publishedYes

Keywords

  • Doppler
  • adverse outcome
  • brain sparing
  • late fetal growth restriction
  • middle cerebral artery

Fingerprint

Dive into the research topics of 'Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction'. Together they form a unique fingerprint.

Cite this