title: Umbilical artery velocimetry in predicting perinatal outcome with intrapartum fetal distress.
abstract: The aim of this study was to see whether umbilical artery Doppler velocimetry predicts intrapartum fetal distress evidenced by poor perinatal outcome. Umbilical velocimetry was performed on 102 parturients with a presumptive diagnosis of fetal distress based on fetal heart rate (FHR) patterns. A mean systolic-diastolic ratio (S/D) of 3 or more after 30 weeks' gestation was considered abnormal. Poor perinatal outcome was defined by any of the following: small for gestational age, low Apgar score, acidosis, meconium below the vocal cords, prolonged neonatal hospital stay, neonatal intensive care unit admission, and neonatal morbidity. Eighty-two patients had normal S/Ds and 20 had abnormal ratios. Eighteen neonates (90%) in the abnormal-SD group had at least one adverse outcome, compared with only 13 (15.8%) of those with a normal S/D, a statistically significant difference (P less than .001). Umbilical artery S/D used as a screening tool to detect poor perinatal outcome had a sensitivity of 65-100%, specificity of 83-92%, positive predictive value of 20-81%, negative predictive value of 91-100%, and a kappa index of 0.24-0.63. These findings suggest that umbilical artery Doppler velocimetry may be useful as an adjunct in the assessment of intrapartum FHR patterns suggesting fetal distress.
authors.affiliation: Department of Obstetrics and Gynecology, King-Drew Medical Center, Los Angeles, California.
authors.forename: D
authors.initials: D
authors.lastname: Ogunyemi
authors.forename: R
authors.initials: R
authors.lastname: Stanley
authors.forename: C
authors.initials: C
authors.lastname: Lynch
authors.forename: D
authors.initials: D
authors.lastname: Edwards
authors.forename: T
authors.initials: T
authors.lastname: Fukushima
mesh_terms: D000328:Adult; D001034:Apgar Score; D001783:Blood Flow Velocity / Q000502:physiology; D005260:Female; D005316:Fetal Distress / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005323:Fetal Monitoring / Q000379:methods; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology; D007236:Infant, Small for Gestational Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*