Details

Autor(en) / Beteiligte

• Mylrea-Foley, Bronacha
• Wolf, Hans
• Stampalija, Tamara
• Lees, Christoph
• Arabin, B.
• Berger, A.
• Bergman, E.
• Bhide, A.
• Bilardo, C. M.
• Breeze, A. C.
• Brodszki, J.
• Calda, P.
• Cetin, I.
• Cesari, E.
• Derks, J.
• Ebbing, C.
• Ferrazzi, E.
• Ganzevoort, W.
• Frusca, T.
• Gordijn, S. J.
• Gyselaers, W.
• Hecher, K.
• Klaritsch, P.
• Krofta, L.
• Lindgren, P.
• Lobmaier, S. M.
• Marlow, N.
• Maruotti, G. M.
• Mecacci, F.
• Myklestad, K.
• Napolitano, R.
• Prefumo, F.
• Raio, L.
• Richter, J.
• Sande, R. K.
• Thornton, J.
• Valensise, H.
• Visser, G. H. A.
• Wee, L.

Titel

Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction

Ist Teil von

• Ultraschall in der Medizin, 2023-02, Vol.44 (1), p.56-67

Erscheinungsjahr

2023

Beschreibungen/Notizen

• 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.