title: Doppler Audio Signal Analysis as an Additional Tool in Evaluation of Umbilical Artery Circulation.
abstract: PurposeTo investigate the predictive capacity of a new method for sound spectrum analysis of Doppler signals recorded from the umbilical artery in high-risk pregnancies.Material and MethodsThe retrospective study comprised 127 pregnant women with various pregnancy complications between 23 and 39 gestational weeks. Umbilical artery blood flow velocity waveforms were recorded with Doppler ultrasound and characterized by pulsatility index (PI) and blood flow class (BFC). Doppler audio signals were stored on a digital video recorder and the sound frequency at the energy level 15 dB below its peak (MAXpeak-15 dB) was estimated off-line. The prediction of probability for composite adverse pregnancy outcome (operative delivery for fetal distress, admission to neonatal intensive care unit, perinatal death) was evaluated using the area under the curve (AUC) of the receiver operating characteristics (ROC) curve.ResultsWith increasing umbilical artery BFC, the MAXpeak-15 dBfrequencies decreased (p < 0.0001) and the PI increased (p < 0.0001). The ROC AUCs for adverse outcome for MAXpeak-15 dBand for PI were 0.842 and 0.836 (p = 0.88), respectively. For the combination of MAXpeak-15 dBand PI, the corresponding AUC was 0.894, significantly higher than that of PI (p < 0.03) and of MAXpeak-15 dB(p < 0.05).ConclusionUmbilical artery Doppler sound spectrum analysis might be a useful supplement to PI in the clinical evaluation of fetoplacental circulation.
authors.affiliation: Obstetrics and Gynecology, Lund University, Lund, Sweden.
authors.forename: Ann
authors.initials: A
authors.lastname: Thuring
authors.affiliation: Reproduction and epidemiology, Lund University, Lund, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Källén
authors.affiliation: Logopedics, phoniatrics and audiology, Lund University, Lund, Sweden.
authors.forename: K Jonas
authors.initials: KJ
authors.lastname: Brännström
authors.affiliation: Biomedical engineering, Lund University, Lund, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Jansson
authors.affiliation: Obstetrics and Gynecology, Lund University, Lund, Sweden.
authors.forename: Karel
authors.initials: K
authors.lastname: Maršál
mesh_terms: D001783:Blood Flow Velocity; D005260:Female; D005317:Fetal Growth Retardation; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology