An evaluation of the efficacy of Doppler flow velocity waveform analysis as a screening test in pregnancy.
In a prospective double-blind study of 535 medium-risk pregnancies, growth data obtained by ultrasonography and Doppler flow velocity waveform systolic to diastolic ratios were recorded at 18, 24, 28, and 34 weeks' gestation. A significant association was observed between uteroplacental systolic to diastolic ratios at 24 weeks' gestation and subsequent fetal hypoxia with a sensitivity of 24.0% and a specificity of 93.9%. However, 70% of abnormal results were not followed by fetal hypoxia. Umbilical artery systolic to diastolic ratios at 24, 28, and 34 weeks' gestation were found to be predictive of intrauterine growth retardation. This predictive capability was enhanced in those growth-retarded fetuses in which hypoxia developed, but was weak when umbilical artery systolic to diastolic ratios were evaluated as primary screening tests for fetal hypoxia. The results confirm a role for Doppler systolic to diastolic ratios in the evaluation of high-risk pregnancies but do not support a role for their use as primary screening tests in low-risk obstetric populations.
Newnham
J P
JP
Ultrasound Department, King Edward Memorial Hospital for Women, Perth, Western Australia.
Patterson
L L
LL
James
I R
IR
Diepeveen
D A
DA
Reid
S E
SE
D000328:Adult; D003971:Diastole; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005311:Fetal Hypoxia / Q000175:diagnosis*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D013599:Systole; D014463:Ultrasonography