Fetal venous Doppler in pregnancies with placental dysfunction and correlation with pH at birth.
OBJECTIVE
To determine the correlation between ph at birth and venous Doppler parameters in pregnancies with placental dysfunction.


METHODS
This was a prospective cohort study of 58 pregnancies with the diagnosis of placental dysfunction between 26 and 34 weeks of gestation. Inclusion criteria were singleton pregnancies, abnormal umbilical artery (UA) Doppler, fetal growth restriction diagnosed by estimated fetal weight <10th centile for gestational age, intact membranes, and absence of fetal congenital abnormalities. The Doppler measurements were the following: UA pulsatility index (PI), ductus venosus (DV) pulsatility index for veins (PIV), intra-abdominal umbilical vein (UV) time-averaged maximum velocity (TAMxV) and blood flow and left portal vein (LPV) time-averaged maximum velocity (TAMxV) and blood flow. All Doppler parameters were transformed into z-scores (SD values from the mean) according to normative references.


RESULTS
The UA pH at birth showed a negative significant correlation with the DV-PIV (p = 0.004) and the DV-PIV z-score (p = 0.004), while LPV TAMxV (p = 0.004), LPV TAMxV z-score (p = 0.002), LPV blood flow (p = 0.01), LPV blood flow normalized (p = 0.04) and UV blood flow (p = 0.04) positively correlated with pH at birth. Multiple regression analysis was performed and the DV-PIV z-score was the variable that independently correlated with pH at birth (p = 0.002).


CONCLUSIONS
the present results suggest that changes in fetal venous blood flow, mainly DV and LPV are useful in the management of cases with early onset placental insufficiency and that venous Doppler parameters correlate with pH at birth.
Department of Obstetrics and Gynecology, São Paulo Medical School, University of São Paulo ,  Sao Paulo ,  Brazil.
Cristiane
C
Ortigosa
Roseli M Y
RM
Nomura
Verbênia N
VN
Costa
Seizo
S
Miyadahira
Marcelo
M
Zugaib
D000328:Adult; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000378:metabolism; D005333:Fetus / Q000098:blood supply; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D036801:Parturition / Q000097:blood / Q000378:metabolism / Q000502:physiology; D010922:Placenta Diseases / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011247:Pregnancy; D018566:Pregnancy, High-Risk / Q000502:physiology; D018608:Ultrasonography, Doppler / Q000379:methods; D014469:Umbilical Arteries / Q000737:chemistry / Q000000981:diagnostic imaging / Q000378:metabolism; D014471:Umbilical Veins / Q000737:chemistry* / Q000000981:diagnostic imaging* / Q000378:metabolism; D055815:Young Adult