scholarly journals Evaluation of Doppler Study of Umbilical Artery in Prolonged Pregnancy– A Study from Andhra Pradesh, India

2021 ◽  
Vol 10 (23) ◽  
pp. 1746-1750
Author(s):  
Vanaja Gundu ◽  
Ganga Devi Chikile ◽  
Geetha Kumari Ponnada
Keyword(s):  
Blood Flow ◽  
Caesarean Section ◽  
Doppler Ultrasound ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
World Health ◽  
Normal Vaginal Delivery ◽  
Doppler Study ◽  
Fetal Surveillance ◽  
Prolonged Pregnancy

BACKGROUND The American College of Obstetricians and Gynecologists (ACOG) and WHO (World Health Organization) define a pregnancy continuing two weeks beyond expected date of delivery as post term pregnancy. Any pregnancy which has passed beyond the expected delivery date is defined as prolonged or post-dated pregnancy. Application of Doppler ultrasound allows for examination of blood flow direction, velocity and volume of various vessels. Doppler velocimetry of umbilical artery in post-dated pregnancy has been suggested as a means of assessing fetal wellbeing. In prolonged pregnancy, the first step of management is an accurate diagnosis and antenatal care includes accurate dating of pregnancy, fetal surveillance and the option of induction of labour or expectant management or Caesarean section. We wanted to analyse the blood flow in umbilical artery using Doppler ultrasound in post-dated pregnancy and analyse the perinatal outcome in post-dated pregnancies with respect to normal and abnormal doppler wave forms. METHODS This is a prospective study conducted at Department of Obstetrics and Gynaecology, Government Victoria Hospital (GVH), Visakhapatnam, from April 2016 to April 2017. 110 pregnant women who were beyond the expected date of delivery (EDD) according to menstrual history and early weeks scan were selected from the antenatal ward and labour room. RESULTS In the present study, 52.73 % women with prolonged pregnancy were primi gravida and 67.27 % women were between the gestational ages of 40 - 41 weeks. Doppler studies were abnormal in 13.64 % (15 women). 78.1 % women with prolonged pregnancy had normal vaginal delivery, Caesarean section was done in 17.3 % and 4.6 % had instrumental delivery. 99.09 % of babies were live born and one was stillborn. Two babies died in early neonatal period due to meconium aspiration. CONCLUSIONS Doppler study of umbilical arteries is a useful noninvasive procedure to reduce the perinatal morbidity and mortality in prolonged pregnancy. KEY WORDS Antepartum Fetal Surveillance, Birth Asphyxia, Doppler Study, Intrauterine Death, Perinatal Outcome, Prolonged Pregnancy, Pulsatility Index, Resistance Index

scholarly journals A study of role of doppler in gestational hypertension and perinatal outcome

2020 ◽  
Vol 9 (8) ◽  
pp. 3458
Author(s):  
Anjali R. Chavda ◽  
Parul T. Shah ◽  
Rina V. Patel ◽  
Hemali N. Patel
Keyword(s):  
Blood Flow ◽  
Doppler Ultrasound ◽  
Perinatal Outcome ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Gestational Hypertension ◽  
Doppler Imaging ◽  
Hypertensive Disorder ◽  
Umbilical Artery Doppler

Background: Hypertensive disorder of pregnancy is one of the most common complications that affect the human pregnancy. Hence it is important to identify women at risk of developing gestational hypertension or preeclampsia, its early diagnosis and subsequent consequences due to uteroplacental insufficiency with help of Doppler ultrasound, to improve perinatal outcome. The objective of this study was to study the application of Doppler ultrasound with analysis of blood flow velocity waveform in gestational hypertension and to examine and study the perinatal outcome in pregnancy with altered Doppler indices.Methods: A prospective study was carried out in 50 antenatal patients diagnosed to have gestational hypertension during a period of 12 months to evaluate the role of color Doppler imaging in gestational hypertension in patients more than 28 weeks of gestation, the initial scan was performed immediately after the diagnosis. This study analyzed the blood flow in umbilical artery, maternal uterine artery and fetal middle cerebral artery using Doppler ultrasound.Results: In this study approximately 76% of cases were found in 20-30 years group. 58% showed abnormal umbilical artery Doppler while 42% women had normal umbilical artery Doppler. In this study 23 cases had cerebro-placental index <1 and 27 cases had cerebro-placental index >1. Cases with cerebro-placental index <1 had various complications like preterm delivery, low birth weight, increased chances of still birth, intra uterine death (IUD), increased NICU admission. In this study 31 cases had abnormal uterine artery Doppler which accounts for 62% of total cases, while 38% had normal uterine artery Doppler.Conclusions: Doppler ultrasound can reliably predict any adverse fetal outcome in hypertensive pregnancies and can be a useful tool for decision making in appropriate timing of intervention for delivery.

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.

scholarly journals Umbilical Artery Doppler Study as a Predictive Marker of Perinatal Outcome in Preterm Small for Gestational Age Infants

2009 ◽  
Vol 50 (1) ◽  
pp. 39 ◽  
Author(s):  
Young Ji Byun ◽  
Haeng-Soo Kim ◽  
Jeong In Yang ◽  
Joon Hyung Kim ◽  
Ho Yeon Kim ◽  
...  
Keyword(s):  
Gestational Age ◽  
Small For Gestational Age ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Predictive Marker ◽  
Doppler Study ◽  
Umbilical Artery Doppler

scholarly journals Perinatal outcome of growth restricted fetus with absent end diastolic umbilical blood flow: Case report

2010 ◽  
Vol 63 (1-2) ◽  
pp. 123-126
Author(s):  
Marija Tasic ◽  
Vekoslav Lilic ◽  
Jelena Milosevic ◽  
Milan Stefanovic ◽  
Vladimir Antic
Keyword(s):  
Blood Flow ◽  
Case Report ◽  
Fetal Growth ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Fetal Monitoring ◽  
Elective Cesarean Section ◽  
Optimal Time ◽  
Biophysical Parameters ◽  
Umbilical Blood

Introduction. Absent or reversed end-diastolic blood flow in the umbilical artery is usually associated with poor perinatal outcome and high perinatal mortality rate. Case report. We present the case of a pregnant woman with absent end-diastolic blood flow in the umbilical artery in the 27th week of pregnancy with initial restriction of fetal growth. All though it was more and more obvious that the fetal growth was hindered, the Doppler, cardiotocographic and biophysical parameters did not get any worse as the pregnancy developed. The full fetal maturation was reached after the intense monitoring of the fetal condition and the pregnancy was terminated in the 37lh week by elective Cesarean section. Conclusion. The basic purpose of prenatal fetal monitoring in the situation of hindered fetal growth with chronic hypoxia is to predict the phase of decompensation and to terminate pregnancy before it is developed. The major problem is in great individual variations at the moment of development of decompensation phase, so the major obstetric aim in the monitoring of the fetus hindered in growth is to determine the optimal time and way of delivery.

Value of a random single Doppler study of the umbilical artery for predicting perinatal outcome.

1991 ◽  
Vol 10 (6) ◽  
pp. 337-339 ◽  
Author(s):  
J S Abramowicz ◽  
S L Warsof ◽  
D M Sherer ◽  
D L Levy ◽  
J R Woods
Keyword(s):  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Doppler Study

scholarly journals To evaluate the tests of antepartum fetal surveillance for predicting adverse perinatal outcome in pregnancy with IUGR

2021 ◽  
Vol 8 (2) ◽  
pp. 235-239
Author(s):  
Mahesh Babu ◽  
Bhavya H U ◽  
Shyam Sundar S
Keyword(s):  
Doppler Ultrasound ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Amniotic Fluid Index ◽  
Tertiary Care Centre ◽  
Adverse Perinatal Outcome ◽  
Biophysical Profile ◽  
Fetal Surveillance ◽  
Sensitivity Specificity ◽  
In Pregnancy

IUGR is one of the most common pregnancy complications which substantially increase risk of adverse neonatal outcome. The sequelae of IUGR include stillbirth, neuro-developmental delay in childhood and high risk of diseases like hypertension, diabetes in adulthood. Therefore, IUGR in pregnancy warrants intensive antepartum fetal surveillance to ensure optimal perinatal outcome.To evaluate the tests of antepartum fetal surveillance like AFI, BPS and Doppler ultrasound, alone and in combination for predicting adverse perinatal outcome in pregnancy with IUGR.This was a prospective observational study done on 100 pregnant IUGR women &#62; 34weeks of gestation, at a tertiary care centre in Karnataka, from June 2017 till December 2018. They were monitored by tests of fetal surveillance like Amniotic Fluid Index (AFI), Bio Physical score (BPS) and Doppler ultrasound. Tests done within 48 hours before labour and its relation to perinatal outcome were assessed. Continuous data such as age, height, weight were described by mean and standard deviation. The sensitivity specificity, positive and negative predictive value were calculated for each test.The statistical difference between the normal and abnormal tests of antepartum fetal surveillance in relation to perinatal outcome was significant. Diagnostic accuracy of Doppler was 67%, BPS and AFI was 69%. In case of combination of findings of BPS and Doppler, the accuracy rose to 75%.Biophysical profile was most reliable diagnostic method than Doppler in predicting adverse outcome. Sensitivity increased when BPS and Doppler was combined which is beneficial in predicting perinatal outcome.

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