Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction : [Longitudinale Doppler-Bewertungen bei später fetaler Wachstumsrestriktion]
Articolo
Data di Pubblicazione:
2023
Citazione:
Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction : [Longitudinale Doppler-Bewertungen bei später fetaler Wachstumsrestriktion] / B. Mylrea-Foley, H. Wolf, T. Stampalija, C. Lees, B. Arabin, A. Berger, E. Bergman, A. Bhide, C.M. Bilardo, A.C. Breeze, J. Brodszki, P. Calda, I. Cetin, E. Cesari, J. Derks, C. Ebbing, E. Ferrazzi, W. Ganzevoort, T. Frusca, S.J. Gordijn, W. Gyselaers, K. Hecher, P. Klaritsch, L. Krofta, P. Lindgren, S.M. Lobmaier, N. Marlow, G.M. Maruotti, F. Mecacci, K. Myklestad, R. Napolitano, F. Prefumo, L. Raio, J. Richter, R.K. Sande, J. Thornton, H. Valensise, G.H.A. Visser, L. Wee. - In: ULTRASCHALL IN DER MEDIZIN. - ISSN 0172-4614. - 44:1(2023 Feb), pp. 56-67. [10.1055/a-1511-8293]
Abstract:
Purpose: To assess the longitudinal variation of the ratio of umbilical and cerebral artery pulsatility index (UCR) in late preterm fetal growth restriction (FGR).
Materials and methods: A prospective European multicenter observational study included women with a singleton pregnancy, 32+ 0-36+ 6, at risk of FGR (estimated fetal weight [EFW] or abdominal circumference [AC] < 10th percentile, abnormal arterial Doppler or fall in AC from 20-week scan of > 40 percentile points). The primary outcome was a composite of abnormal condition at birth or major neonatal morbidity. UCR was categorized as normal (< 0.9) or abnormal (≥ 0.9). UCR was assessed by gestational age at measurement interval to delivery, and by individual linear regression coefficient in women with two or more measurements.
Results: 856 women had 2770 measurements; 696 (81 %) had more than one measurement (median 3 (IQR 2-4). At inclusion, 63 (7 %) a UCR ≥ 0.9. These delivered earlier and had a lower birth weight and higher incidence of adverse outcome (30 % vs. 9 %, relative risk 3.2; 95 %CI 2.1-5.0) than women with a normal UCR at inclusion. Repeated measurements after an abnormal UCR at inclusion were abnormal again in 67 % (95 %CI 55-80), but after a normal UCR the chance of finding an abnormal UCR was 6 % (95 %CI 5-7 %). The risk of composite adverse outcome was similar using the first or subsequent UCR values.
Conclusion: An abnormal UCR is likely to be abnormal again at a later measurement, while after a normal UCR the chance of an abnormal UCR is 5-7 % when repeated weekly. Repeated measurements do not predict outcome better than the first measurement, most likely due to the most compromised fetuses being delivered after an abnormal UCR.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
late fetal growth restriction; Doppler; middle cerebral artery; brain sparing; adverse outcome
Elenco autori:
B. Mylrea-Foley, H. Wolf, T. Stampalija, C. Lees, B. Arabin, A. Berger, E. Bergman, A. Bhide, C.M. Bilardo, A.C. Breeze, J. Brodszki, P. Calda, I. Cetin, E. Cesari, J. Derks, C. Ebbing, E. Ferrazzi, W. Ganzevoort, T. Frusca, S.J. Gordijn, W. Gyselaers, K. Hecher, P. Klaritsch, L. Krofta, P. Lindgren, S.M. Lobmaier, N. Marlow, G.M. Maruotti, F. Mecacci, K. Myklestad, R. Napolitano, F. Prefumo, L. Raio, J. Richter, R.K. Sande, J. Thornton, H. Valensise, G.H.A. Visser, L. Wee
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