Venous-arterial Doppler ratios in the prediction of acidemia at birth in pregnancies with placental insufficiency.
OBJECTIVE
Investigate the prediction of birth acidemia in pregnancies with placental insufficiency using two newly created venous-arterial Doppler ratios: pulsatility index (PI) of the ductus venosus (DV) over PI of the middle cerebral artery (MCA) and PI of the DV over PI of the umbilical artery and establish cut-off values for this prediction.


METHODS
This was a prospective cross-sectional study involving 47 patients with placental insufficiency managed in two Brazilian hospitals. All pregnancies were singleton, over 26 weeks of age and without structural or chromosome anomalies. A ROC curve was calculated for the venous-arterial ratios (independent variable) and acidemia (dependent variable).


RESULTS
The DV/AU PI ratio was not a good predictor of acidemia at birth. The DV/MCA PI ratio was related to fetal acidemia (area under the ROC curve 0.785, p = 0.004). The cut-off value was 0.582, sensibility 66.7%, specificity 77.1% and accuracy 74.5%.


CONCLUSIONS
The DV/MCA PI ratio is adequate for the diagnosis of acidemia at birth in pregnancies with placental insufficiency. The cut-off value was 0.582.
Carvalho
F H C
FH
São Paulo Hospital, São Paulo Federal University, Paulista Medical School, Fortaleza, Brazil. herlaniocosta@uol.com.br
Moron
A F
AF
Mattar
R
R
Murta
C G V
CG
Santana
R M
RM
Barbosa
M M
MM
Torloni
M R
MR
Vasques
F A P
FA
D000138:Acidosis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D001158:Arteries; D003430:Cross-Sectional Studies; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D020768:Middle Cerebral Artery; D010927:Placental Insufficiency / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018617:Ultrasonography, Doppler, Pulsed; D014469:Umbilical Arteries; D014680:Veins / Q000196:embryology