Added value of umbilical vein flow as a predictor of perinatal outcome in term small-for-gestational-age fetuses
Added value of umbilical vein flow as a predictor of perinatal outcome in term small-for-gestational-age fetuses
复制标题
DOI：
10.1002/uog.12380
复制
发表时间：
2013-08-01
影响因子：
7.1
通讯作者：
Figueras, F.
中科院分区：
文献类型：
--
作者：
Parra-Saavedra, M.;Crovetto, F.;Figueras, F.
目的比较脐静脉（UV）血流与标准多普勒血流参数对晚发型小于胎龄儿（SGA）围生期不良结局的预测价值。结果53例（27%）胎儿有不安全的胎儿状态需要紧急分娩，而21例（11%）新生儿发生代谢性酸中毒。多变量分析显示，大脑中动脉（MCA）搏动指数（PI）和胎儿体重标准化的UV血流对预测胎儿不安全状态和新生儿代谢性酸中毒的紧急分娩有重要贡献。决策树分析定义了三组因胎儿状态不安全而需要紧急分娩的风险增加：MCA-PI > 1.46（风险15.6%）; MCA-PI 68 mL/min/kg（风险25%）; MCA-PI> 1.46（风险25%）。
Objective To compare umbilical vein (UV) flow with standard Doppler parameters in prediction of adverse perinatal outcome in late-onset small-for-gestational age (SGA) fetuses.Methods Umbilical, uterine and middle cerebral arteries, and UV blood flow were evaluated by Doppler before delivery in a cohort of 193 term SGA fetuses. The value of the Doppler parameters to predict risk of emergency delivery for non-reassuring fetal status and neonatal metabolic acidosis was analyzed.Results Fifty-three (27%) fetuses had non-reassuring fetal status requiring emergency delivery, whereas 21 (11%) newborns developed neonatal metabolic acidosis. Multivariable analysis showed that significant contributions to prediction of emergency delivery for non-reassuring fetal status and neonatal metabolic acidosis were provided by middle cerebral artery (MCA) pulsatility index (PI) and UV blood flow normalized by fetal weight. Decision tree analysis defined three groups with increasing risk of need for emergency delivery for non-reassuring fetal status: MCA-PI > 1.46 (risk 15.6%); MCA-PI 68 mL/min/kg (risk 25%); and MCA-PI