Risk of Perinatal Death in Early-Onset Intrauterine Growth Restriction according to Gestational Age and Cardiovascular Doppler Indices: A Multicenter Study

2012 ◽  
Vol 32 (1-2) ◽  
pp. 116-122 ◽  
Author(s):  
Mónica Cruz-Lemini ◽  
Fàtima Crispi ◽  
Tim Van Mieghem ◽  
Daniel Pedraza ◽  
Rogelio Cruz-Martínez ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Gestational Age ◽  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Perinatal Death ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Indices

scholarly journals Early Uterine and Umbilical Artery Doppler Indices as Predictor for Preeclampsia and Intrauterine Growth Restriction

2021 ◽  
pp. 116-126
Author(s):  
Sara E. Khalil ◽  
Mohammed M. Elnamory ◽  
Mona K. omar ◽  
Hesham M. Eltokhy
Keyword(s):  
Gestational Age ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Study ◽  
Significant Difference ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

Background: Preeclampsia (PE) is a disorder that causes hypertension and proteinuria after week 20 of pregnancy. Several Uterine Artery (UtAs) Doppler characteristics have been investigated for their ability to predict PE. The purpose of this research is to look into the uterine and umbilical arterial Doppler indices in the early second trimester for the prediction of late preeclampsia or intrauterine growth restriction. Methods: This is a prospective cohort clinical study and was done at Obstetrics and Gynecology department, faculty of medicine Tanta university hospital from January 2020 till April 2021. 150 pregnant women aged from 18 to 30 years old with gestational age from 13 to 16 weeks of pregnancy. Study was done by the same observer by machine MINDRAY DC60 Measurement of fetal biometry (BPD, FL, AC, HC) Gestational age was confirmed with Detection of congenital malformation.    Results: There is a significant difference between the groups regarding uterine and umbilical artery doppler Indices. Uterine RI only yielded significance for predicting IUGR with sensitivity of 62% and specificity of 88%, with Positive predictive value (PPV) 37% and Negative predictive value (NPV) 92%. Umbilical resistance index achieved sensitivity of 56% and specificity of 82%, with PPV 31% and NPV 30% with on statistical significance. Conclusions: Combination of uterine and umbilical artery Doppler study in early pregnancy is one of the best indicator for prediction of preeclampsia and IUGR. Therefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality.

scholarly journals Study protocol for a randomised controlled trial: treatment of early intrauterine growth restriction with low molecular weight heparin (TRACIP)

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e020501
Author(s):  
Edurne Mazarico ◽  
Anna Peguero ◽  
Marta Camprubí ◽  
Carlota Rovira ◽  
Maria Dolores Gomez Roig ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Gestational Age ◽  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Low Molecular Weight Heparin ◽  
Adult Life ◽  
Growth Restriction ◽  
Low Molecular Weight ◽  
Intrauterine Growth ◽  
Link Type

IntroductionThe incidence of intrauterine growth restriction (IUGR) is estimated at about 3% of pregnancies, and it is associated with 30% of all perinatal mortality and severe morbidity with adverse neurodevelopmental and cardiovascular health consequences in adult life. Early onset IUGR represents 20%–30% of all cases and is highly associated with severe placental insufficiency. The existing evidence suggests that low molecular weight heparin (LMWH) has effects beyond its antithrombotic action, improving placental microvessel structure and function of pregnant women with vascular obstetric complications by normalising proangiogenic and antiapoptotic protein levels, cytokines and inflammatory factors. The objective of our study is to demonstrate the effectiveness of LMWH in prolonging gestation in pregnancies with early-onset IUGR.Methods and analysisThis is a multicentre, triple-blind, parallel-arm randomised clinical trial. Singleton pregnancies qualifying for early (20–32 weeks at diagnosis) placental IUGR (according to Delphi criteria) will be randomised to subcutaneous treatment with bemiparin 3500 IU/0.2 mL/day or placebo from inclusion at diagnosis to the time of delivery. Analyses will be based on originally assigned groups (intention-to-treat). The primary objective will be analysed by comparing gestational age and prolongation of pregnancy (days) in each group with Student’s t-tests for independent samples and by comparing Kaplan-Maier survival curves (from inclusion to delivery, log-rank test). A linear regression model for gestational age at birth will consider the following covariates: gestational age at inclusion (continuous) and pre-eclampsia (binary).Ethics and disseminationThe study will be conducted in accordance with the principles of Good Clinical Practice. This study was approved by the Clinical Research Ethics Committee (CEIC) of Sant Joan de Déu Hospital, on 13 July 2017. The trial is registered in the public registrywww.clinicaltrial.gov. according to Science Law 14/2011, and the results will be published in an open access journal.Trial registration numberNCT03324139; Pre-results.

scholarly journals ALTERED ARTERIAL DOPPLER FLOW PATTERN AND PERINATAL OUTCOME IN INTRAUTERINE GROWTH RESTRICTION

2017 ◽  
Vol 10 (3) ◽  
pp. 425
Author(s):  
Kiran Kumar Shetty ◽  
Krishnananda Nayak ◽  
Pratap Kumar ◽  
Ranjan Shetty ◽  
Jyothi . ◽  
...  
Keyword(s):  
Flow Pattern ◽  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Growth Restriction ◽  
Doppler Flow ◽  
Intrauterine Growth ◽  
Wide Range ◽  
Doppler Indices

ABSTRACTObjectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15%of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limiteddata available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study theperinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age.Methods: This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was madeaccording to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuseswith healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography(ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at southIndian tertiary care center.Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGRgroups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was notevident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamberquantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than thecontrol group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group,whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among twogroups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGRgroup also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001).Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverseperinatal outcome. This study showed significant perinatal mortality accounting for 5.6% among IUGR cases when compared to normal. Althoughtissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared tosevere form of IUGR subsets who show altered tissue annular velocities.Keywords: Intrauterine growth restriction, Echocardiography, Doppler, Perinatal.

scholarly journals Results of the perinatal audit of the Northwestern Federal District

2020 ◽  
Vol 101 (5) ◽  
pp. 727-733
Author(s):  
D O Ivanov ◽  
K G Shevtsova ◽  
K E Moiseeva ◽  
Sh D Harbedia
Keyword(s):  
Gestational Age ◽  
Intrauterine Growth Restriction ◽  
Congenital Malformations ◽  
Perinatal Death ◽  
Statistical Significance ◽  
Federal District ◽  
Perinatal Period ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Perinatal Audit

Aim. To assess the results of a perinatal audit of the Northwestern Federal District and to identify opportunities for a decrease in perinatal mortality. Methods. The audit of perinatal loss was conducted in two stages: (1) remote audit audit of perinatal mortality indicators; (2) medical history audit audit of cases of perinatal death of a child based on medical documentation. Held the copy of the data from the 925 medical records for 220 cases of perinatal death. The perinatal audit of the Northwestern Federal District used the Nordic-Baltic perinatal death classification. The following statistical methods were used for statistical data processing: incidence rate of a trait was determined by using frequency tables, the statistical significance of differences was tested by using contingency tables, the Chi-square criterion, along with the Pearson correlation coefficient. The statistical significance of differences in quantitative indicators was assessed by using Student's t-Test. The significance level was set at p 0.05. Results. It was found that in the Northwestern Federal District pregnancy losses III category of the Nordic-Baltic classification (gestational age newborn, more than 28 weeks, without congenital malformations and intrauterine growth restriction) is 27.5%, intranatal losses VI category of the Nordic-Baltic classification (gestational age newborn, more than 28 weeks, without congenital malformations and intrauterine growth restriction) 7.4%, the loss of newborns VIIIXI category of the Nordic-Baltic classification (gestational age newborn, more than 28 weeks, without congenital malformations and intrauterine growth restriction) 16.9%. Among children who died during the perinatal period, children of gestational age over 28 weeks significantly predominate (p=0.003). In the nosological structure of stillbirth, most of the diseases are associated with respiratory disorders (85.9%), infectious complications are 14.1%. The main causes of death of newborns in the early neonatal period are respiratory disorders 40.0% and infectious diseases specific to the perinatal period 36.0%. The assessment of the sexual prevalence of pregnancy losses did not reveal a statistically significant difference (p=0.29). The assessment of the sexual characteristics of intranatal losses showed that boys significantly predominate (p=0.003). Conclusion. The perinatal audit revealed that, in the Northwestern Federal District, the level of the mobile reserve of perinatal losses associated with managed causes is 51.8%.

scholarly journals UTERINE ARTERY DOPPLER INDICES AS PREDICTIVE MEASURES FOR THE PRE-ECLAMPSIA AND INTRAUTERINE GROWTH RESTRICTION

2020 ◽  
Vol 2020 (1) ◽  
Author(s):  
MN Rashid ◽  
M Kari ◽  
R Rashid ◽  
MA Rana ◽  
A Amjad ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Uterine Artery ◽  
Growth Restriction ◽  
Cross Sectional Survey ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Uterine Artery Doppler ◽  
Intrauterine Growth ◽  
Pregnant Females ◽  
Doppler Indices

Preeclampsia and Intrauterine growth restriction (IUGR) remains as the important causes for the neonatal and maternal complications leading to even death in some cases. Uterine artery Doppler USG can be done transvaginally or trans abdominal and performed in the 1st or 2nd trimester of the pregnancy to detect these complications Doppler waveform suggested the high vascular resistance to blood flow. In our present study, we conclude uterine artery Doppler indices as prognostic procedure for the preeclampsia and intrauterine growth restriction. A cross-sectional survey design with convenient sampling technique was used. Mixture of standardized and self-modified structured questionnaire was undertaken to determine the indices of pre eclampsia and IUGR by uterine artery. The data was collected from Bahria International Hospital, Lahore during the period of 9 months. This study was included 162 pregnant females with identification of the main uterine artery on a longitudinal scan lateral to the uterus.  Initial diastolic notch of right and left side of the uterine artery waveforms was recorded. At every antenatal checkup, urine was tested for protein and blood pressure readings were taken to identify preeclampsia. Further analysis was done dividing patients as normotensive and those patients developing hypertension after 30 weeks of gestation. After delivery neonates observed for IUGR by head circumference and body weight. The study was concluded that from the total sample size of 162 pregnant females who undergoes uterine artery Doppler, 34% females shows diastolic notch and almost all of these later diagnosed with preeclampsia and 19.8% deliver babies with IUGR. So, based on the study, we have concluded that uterine artery Doppler is helpful to provide diagnosis of preeclampsia and IUGR in early pregnancy.

Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction

2019 ◽  
Vol 47 (8) ◽  
pp. 841-846 ◽  
Author(s):  
Murat Akbas ◽  
Faik M. Koyuncu ◽  
Burcu Artunç-Ulkumen
Keyword(s):  
Pregnant Women ◽  
Shear Wave ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Shear Wave Elastography ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
The Mean ◽  
Adverse Perinatal Outcomes ◽  
Doppler Indices

Abstract Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

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