Doppler umbilical velocimetry in the prediction of adverse outcome in pregnancies at risk for intrauterine growth retardation.
Perinatal indicators of fetal compromise were assessed according to the results of continuous-wave Doppler umbilical velocimetry for 172 patients at risk for intrauterine growth retardation (IUGR). Forty-three (25%) of the patients delivered an infant with a birth weight below the tenth percentile for gestational age. The last Doppler study before delivery was abnormal in 48.8% of the growth-retarded infants but in only 13.2% of the infants without evidence of IUGR. Furthermore, in the growth-retarded group, early delivery, reduced birth weight, decreased amniotic fluid at birth, admission to the neonatal intensive care unit, neonatal complications associated with IUGR, and a prolonged hospital stay were observed more frequently in those who had an abnormal ratio than in those with a normal ratio. The sensitivity of the systolic/diastolic ratio for an adverse perinatal outcome (operative delivery for fetal distress, neonatal morbidity associated with IUGR, and/or perinatal death) was significantly better for the infants with IUGR (66.7%) than for the infants without IUGR (27.8%; P less than .05). The predictive value of an abnormal ratio was also higher for the pregnancies complicated with IUGR (57.1%) than for those without IUGR (29.4%), but not to a statistically significant degree. These data suggest that Doppler umbilical velocimetry studies are valuable in identifying those growth-retarded fetuses at increased risk for an adverse perinatal outcome.
Berkowitz
G S
GS
Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine, New York, New York.
Mehalek
K E
KE
Chitkara
U
U
Rosenberg
J
J
Cogswell
C
C
Berkowitz
R L
RL
D001783:Blood Flow Velocity; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis; D005317:Fetal Growth Retardation / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007902:Length of Stay; D010920:Placenta / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D014463:Ultrasonography