Can umbilical artery pulsatility index predict the outcome of fetuses with structural heart disease?
Umbilical artery Doppler waveforms have been suggested to demonstrate diminished end-diastolic velocities in anomalous fetuses. We evaluated 11 fetuses with antenatally diagnosed congenital heart disease (CHD) and compared them to a normal population. Fetuses with CHD were studied once each and ranged in age from 19 to 32 weeks gestation. Eight had normal chromosomes, and three were aneuploid. The pulsatility index (PI) was elevated (above the 90th percentile for gestational age) in 3/11 CHD fetuses (P = NS). Elevated PI did not discriminate well between those with fatal and nonfatal lesions. Although all three fetuses with elevated PI had fatal disease, five of eight fetuses with fatal anomalies had normal PI values. We conclude that, while umbilical artery PI values were elevated in a subgroup of affected fetuses, this was not clinically helpful.
Copel
J A
JA
Yale Fetal Cardiovascular Center, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510-8063.
Hobbins
J C
JC
Kleinman
C S
CS
D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000235:genetics / Q000401:mortality; D006801:Humans; D007621:Karyotyping; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D011673:Pulsatile Flow / Q000502:physiology; D015996:Survival Rate; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*