Integrated monitoring of fetal growth restriction by computerized cardiotocography and Doppler flow velocimetry.
OBJECTIVE
To investigate the correlations between Doppler flow velocimetry and computerized cardiotocography (cCTG) in fetal growth restriction.


METHODS
Fifty growth-restricted foetuses with abdominal circumference below the 10th percentile and no major abnormalities were studied. A total of 186 cCTG tracings (at least two per patient) analysed using the HP2CTG system were compared with the corresponding umbilical artery pulsatility index (PI), the PI ratio of umbilical artery to middle cerebral artery, and the ductus venosus systolic/atrial ratio.


RESULTS
Worsening in umbilical artery Doppler velocimetry parameters was associated with a significant reduction of short- and long-term variability indices and accelerations. When end-diastolic umbilical artery flow was preserved, a reversed ratio between umbilical artery and middle cerebral artery PIs was not correlated with a worsening of cCTG parameters; in the presence of umbilical artery absent or reversed flow, ductus venosus Doppler velocimetry abnormalities were correlated with a significant reduction of variability. When end-diastolic umbilical artery flow was preserved, there was a progressive increase in variability indices and accelerations with advancing gestational age. In the more compromised fetuses this "maturation" process of cCTG patterns was not found.


CONCLUSIONS
There is a strict correlation between Doppler velocimetry abnormalities and cCTG parameter deterioration, in particular between ductus venosus and variability.
Soncini
Emanuele
E
Department of Gynaecology, Obstetrics and Neonatology, University of Parma, Parma, Italy. soncio@tin.it
Ronzoni
Elena
E
Macovei
Doina
D
Grignaffini
Alessandro
A
D001783:Blood Flow Velocity / Q000502:physiology; D015148:Cardiotocography; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D017078:Laser-Doppler Flowmetry; D020768:Middle Cerebral Artery / Q000002:abnormalities / Q000502:physiology*; D010927:Placental Insufficiency / Q000503:physiopathology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000002:abnormalities / Q000502:physiology*