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.

scholarly journals Sildenafil citrate therapy in absent end diastolic flow in umbilical artery in an early onset fetal growth restriction (FGR) fetus

2018 ◽  
Vol 7 (12) ◽  
pp. 5173
Author(s):  
Rana A. Choudhary ◽  
Khyati Patrawala ◽  
Kavita Desai ◽  
Kedar Ganla
Keyword(s):  
Blood Flow ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Early Onset ◽  
Umbilical Artery ◽  
Fetal Outcome ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Optimal Time ◽  
Diastolic Flow

Fetal growth restriction (FGR), a pregnancy complication still poses as a challenge for obstetricians worldwide. This is because of its association with severe morbidity and mortality outcomes. Obstetrical management becomes a dilemma in determining the optimal time of delivery and weighing the risks of prematurity against the risks of a potentially hostile intrauterine environment. There may be placental insufficiency characterized by insufficient blood flow in the umbilical artery. This is termed as abnormal umbilical artery flow with absent or reversed end diastolic flow on Doppler USG. Worsening of this condition demands an earlier delivery of the fetus. Authors report a case of structurally normal foetus showing severe early onset FGR with absent end diastolic flow in umbilical artery on Doppler, which was managed using vaginal Sildenafil citrate. Sildenafil citrate led to improvement in uterine artery and umbilical artery Doppler parameters; thereby improving the utero-placental blood flow with a favorable fetal outcome at delivery. The gestation was prolonged by 51 days. Thus, Sildenafil citrate can be used as promising agent in early onset FGR in selected cases.

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 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

Umbilical Blood Flow and Glucose Uptake in Lamb Fetus Following Single Umbilical Artery Ligation

Neonatology ◽  
1975 ◽  
Vol 26 (3-4) ◽  
pp. 291-299 ◽  
Author(s):  
William Oh ◽  
Keiichiro Omori ◽  
Calvin J. Hobel ◽  
Allen Erenberg ◽  
George C. Emmanouilides
Keyword(s):  
Blood Flow ◽  
Glucose Uptake ◽  
Umbilical Artery ◽  
Single Umbilical Artery ◽  
Artery Ligation ◽  
Umbilical Blood ◽  
Umbilical Blood Flow

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.

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