title: Elevated umbilical artery systolic/diastolic ratio in the absence of fetal growth restriction.
abstract: OBJECTIVE
  To evaluate whether patients with isolated elevation of umbilical artery (UA) systolic/diastolic (S/D) ratio are at increased risk for adverse perinatal outcome.
  
  
  METHODS
  This is a retrospective cohort study of 330 patients who underwent routine evaluation at our maternal fetal medicine center. We regularly perform UA S/D ratio analysis with every third trimester sonogram. All identified patients were included and divided into four groups based on estimated fetal weight (EFW) and UA S/D ratio. Perinatal outcome was compared between the groups.
  
  
  RESULTS
  Regardless of the EFW, fetuses with persistent elevated UA S/D ratio showed significantly more preterm deliveries (p < .001), neonatal intensive care unit (NICU) admissions (p < .001), longer stay in the NICU (p < .001) and lower birth weight (p < .001) relative to controls. Stepwise logistic regression analysis demonstrated that being a member in any study group significantly and independently predicted birth weight less than the 10th percentile and preterm delivery. Patients with persistently elevated S/D ratio were significantly and independently from other factors, more likely to have a newborn admitted to the NICU.
  
  
  CONCLUSIONS
  Our results indicate a suboptimal perinatal outcome in all pregnancies with an elevated UA S/D ratio. These fetuses may benefit from intensive monitoring.
authors: Department of Obstetrics and Gynecology, Lenox Hill Hospital, 100 East 77th Street, New York, NY 10075, USA. GFilmar@gmail.com
authors: Gilad
authors: G
authors: Filmar
authors: Georgia
authors: G
authors: Panagopoulos
authors: Victoria
authors: V
authors: Minior
authors: Yoni
authors: Y
authors: Barnhard
authors: Michael Y
authors: MY
authors: Divon
mesh_terms: D000328:Adult; D001724:Birth Weight; D001783:Blood Flow Velocity; D016001:Confidence Intervals; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging; D020567:Fetal Weight; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007902:Length of Stay; D016017:Odds Ratio; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000209:etiology*; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology*