Cardiac Measurements of Size and Shape in Fetuses With Absent or Reversed End‐Diastolic Velocity of the Umbilical Artery and Perinatal Survival and Severe Growth Restriction Before 34 Weeks' Gestation

2020 ◽  
Author(s):  
Greggory R. DeVore ◽  
Percy Pacora Portella ◽  
Edgar Hernandez Andrade ◽  
Lami Yeo ◽  
Roberto Romero
Keyword(s):  
Umbilical Artery ◽  
Growth Restriction ◽  
Size And Shape ◽  
Diastolic Velocity ◽  
Severe Growth ◽  
Perinatal Survival

scholarly journals Correlation of Doppler assessment of fetal aortic isthmus with perinatal outcome in intrauterine growth restriction

2018 ◽  
Vol 7 (9) ◽  
pp. 3780
Author(s):  
Bhoomika Tantuway ◽  
Y. M. Mala ◽  
Anju Garg ◽  
Reva Tripathi
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Additional Parameter ◽  
Intrauterine Death ◽  
Aortic Isthmus ◽  
Diastolic Velocity

Background: The objective of the present study was to find out association between aortic isthmus Doppler changes and perinatal outcome in growth restricted fetuses with placental insufficiency.Methods: It is a prospective case control study, cases were 43 pregnant women with fetal growth restriction (FGR) with abnormal umbilical artery (UA) Doppler while 43 pregnant women with FGR but normal UA doppler, matched with period of gestation were taken as control. The direction of blood flow in aortic isthmus studied which may be antegrade, absent or retrograde and correlation between qualitative parameters of umbilical artery, aortic isthmus and ductus venosus were studied. Quantitative parameters, PI and RI were also calculated. Patients were managed as per hospital protocols. Perinatal outcome and any adverse event e.g. stillbirth, neonatal death, respiratory distress syndrome, intensive care unit stay >14 days etc. was noted.Results: The number of intrauterine death (IUD) and still birth was increased in women with absent and retrograde flow in aortic isthmus, 66.7% and 71.4% respectively (p value <0.001). Retrograde blood flow in the aortic isthmus is consistently associated with absent or reverse end diastolic velocity in umbilical artery and ductus venosus.Conclusions: Doppler of aortic isthmus is an additional parameter to assess severity of FGR. It plays an important role in termination of preterm FGR fetuses.

Umbilical Artery Half-Peak Systolic Velocity Deceleration Time in Fetal Growth Restriction

2015 ◽  
Vol 40 (2) ◽  
pp. 128-134 ◽  
Author(s):  
Juan Carlos Bustos ◽  
Vivian Gonzalez ◽  
Waldo Sepulveda
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Perinatal Death ◽  
Peak Systolic Velocity ◽  
Growth Restriction ◽  
Ultrasound Evaluation ◽  
Diastolic Velocity ◽  
Deceleration Time

Objective: To study the umbilical artery (UA) half-peak systolic velocity deceleration time (hPSV-DT) in pregnancies complicated by fetal growth restriction (FGR). Methods: The study included 266 singleton, high-risk pregnancies with an estimated fetal weight <10th percentile, which were examined between 24 and 40 weeks' gestation and delivered within a week from the last ultrasound evaluation. UA hPSV-DT was measured with Doppler ultrasound in the same wave used to measure the pulsatility index. UA hPSV-DT values were correlated with perinatal outcome. Results: UA hPSV-DT <5th percentile was found in 87 and 98% of fetuses with moderate and severe FGR, respectively. 94% of fetuses with a UA hPSV-DT <90 ms had poor perinatal outcome including perinatal death or prolonged admission to the neonatal intensive care unit. None of the fetuses had a UA hPSV-DT <70 ms. Perinatal death occurred in 39 fetuses; UA hPSV-DT was abnormal in all of them, with 95% of these fetuses having values of ≤120 ms. In the group of fetuses with absent/reverse end-diastolic velocity in the UA, the perinatal mortality rate was 51% for those with a UA hPSV-DT ≤90 ms and only 23% for those having a UA hPSV-DT >90 ms (p < 0.01). Conclusions: UA hPSV-DT seems to be a useful technique in the evaluation of pregnancies at risk for FGR and perinatal death. Additionally, hPSV-DT was shown to be a good predictor of perinatal death, with values of <90 ms corresponding to imminent risk of intrauterine demise and values of <70 ms being likely to be incompatible with intrauterine life.

scholarly journals Intermediate Diastolic Velocity as a Parameter of Cardiac Dysfunction in Growth-Restricted Fetuses

2015 ◽  
Vol 39 (1) ◽  
pp. 28-39 ◽  
Author(s):  
Xiangna Tang ◽  
Edgar Hernandez-Andrade ◽  
Hyunyoung Ahn ◽  
Maynor Garcia ◽  
Homam Saker ◽  
...  
Keyword(s):  
Cardiac Dysfunction ◽  
Umbilical Artery ◽  
Perinatal Death ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Atrioventricular Valves ◽  
Diastolic Velocity ◽  
Cardiac Ventricles ◽  
Restriction Methods

Objective: To evaluate the intermediate intracardiac diastolic velocities in fetuses with growth restriction. Methods: Doppler waveforms of the two atrioventricular valves were obtained. Peak velocities of the E (early) and A (atrial) components, and the lowest intermediate velocity (IDV) between them, were measured in 400 normally grown and in 100 growth-restricted fetuses. The prevalence of abnormal IDV, E/IDV, and A/IDV ratios in fetuses presenting with perinatal death or acidemia at birth (pH ≤7.1) was estimated. Results: IDV was significantly lower and E/IDV ratios significantly higher in the two ventricles of growth-restricted fetuses with reduced diastolic velocities in the umbilical artery (p < 0.05). In 13 fetuses presenting with perinatal death or acidemia at birth, 11 (85%) had either an E/IDV or A/IDV ratio >95th percentile, whereas 5 (38%) showed absent or reversed atrial velocities in the ductus venosus (DV-ARAV; p < 0.04). Fetuses without DV-ARAV but with elevated E/IDV ratios in either ventricle were nearly 7-fold more likely to have perinatal demise or acidemia at birth (OR 6.9, 95% CI 1.4-34) than those with E/IDV ratios <95th percentile. Conclusion: The E/IDV and A/IDV ratios in the two cardiac ventricles might provide information about the risk of perinatal demise or acidemia in growth-restricted fetuses.

scholarly journals The role of sildenafil citrate in the treatment of fetal growth restriction: a randomized controlled trial

2019 ◽  
Vol 8 (5) ◽  
pp. 1840
Author(s):  
Ahmed Abdelshafy ◽  
Khaled Ibrahim Abdullah ◽  
Sherif Ashoush ◽  
Heba E. Hosni
Keyword(s):  
Middle Cerebral Artery ◽  
Fetal Growth ◽  
Cerebral Artery ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Controlled Trial ◽  
Maternity Hospital ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Doppler Velocity

Background: This study was aimed to evaluate the effect of sildenafil citrate on Doppler velocity indices in patients with fetal growth restriction (FGR) associated with impaired placental circulation.Methods: A double-blinded, parallel group randomized clinical trial (clinicaltrials.gov NCT02590536) was conducted in Ain Shams Maternity Hospital, in the period between October 2015 and June 2017. Ninety pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were randomized to either sildenafil citrate 25 mg orally every 8 hours or placebo visually-identical placebo tablets with the same regimen. The primary outcome of the study was the change in umbilical artery and fetal middle cerebral artery indices.Results: There was a significant improvement in umbilical and middle cerebral artery indices after sildenafil administration p<0.001. Present study observed that, sildenafil group, in comparison to placebo, has a significantly higher mean neonatal birth weight. 1783±241g vs 1570±455g (p<0.001). There was a significantly higher mean gestational age at delivery in women in sildenafil group 35.3±1.67 weeks, whereas it was lower in the placebo group 33.5±1.7 weeks. The side effects as headache, palpitation and facial flushing were significantly higher in sildenafil group compared to placebo group.Conclusions: The use sildenafil citrate in pregnancies with fetal growth restriction (FGR) improved the feto-placental Doppler indices (pulsatility index of umbilical artery and middle cerebral artery) and improved neonatal outcomes.

Umbilical artery extracellular matrix remodeling in fetal growth restriction

2004 ◽  
Vol 191 (6) ◽  
pp. S10
Author(s):  
Wendy Kinzler ◽  
John Smulian ◽  
C. Andrew Kistler ◽  
Rita Hahn ◽  
Peihong Zhou ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Extracellular Matrix Remodeling ◽  
Matrix Remodeling

Umbilical artery Doppler changes in fetal growth restriction with intermittently absent umbilical artery end-diastolic flow

2022 ◽  
Vol 226 (1) ◽  
pp. S386-S387
Author(s):  
Eileen Xu ◽  
Nandini Raghuraman ◽  
Katherine H. Bligard ◽  
Jeffrey Dicke ◽  
Anthony O. Odibo ◽  
...  
Keyword(s):  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Diastolic Flow ◽  
Umbilical Artery Doppler
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