Perinatal outcome in fetuses with loss of end-diastolic blood flow velocities in the descending aorta and/or umbilical arteries.
Continuous- and pulsed-wave Doppler velocimetry was used as an additional method of antenatal surveillance in high-risk pregnancy care. During a 30-month period with 4,169 deliveries 226 patients (5.4%) with complicated pregnancies (intrauterine growth retardation, diabetes, hypertension) were investigated. The results had only marginal influence on obstetrical management. In 38 fetuses absence of end-diastolic blood flow velocities (AEDF) was detected in the descending fetal aorta and/or umbilical arteries. Mean birth weight of these fetuses was 1,441 +/- (SD) 690 g at a mean gestational age of 31.8 +/- 6.8 weeks at birth. Twenty fetuses (53%) were growth-retarded (less than 3rd centile). Six fetuses died in utero and 7 during the perinatal period (34% mortality). There was a significant deterioration of perinatal outcome with AEDF in the umbilical arteries at the last antenatal Doppler scan. With AEDF in the descending fetal aorta the Doppler parameter Vmean and with AEDF in the umbilical arteries the pulsatility index yielded additional prognostic information. Doppler velocimetry of the fetal and umbilical vascular system could be of additional value for antenatal surveillance in high-risk pregnancies.
Hüneke
B
B
Department of Obstetrics and Gynecology, University Hospital Eppendorf, University of Hamburg, FRG.
Carstensen
M H
MH
Schröder
H J
HJ
Günther
M
M
D000328:Adult; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D001724:Birth Weight; D001783:Blood Flow Velocity; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging