Longitudinal Doppler Assessments in Late Preterm Fetal Growth Restriction.

Autor:	Mylrea-Foley B; Institute for Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, UK.; Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS., Wolf H; Department of Obstetrics and Gynecology, Amsterdam University Medical Center (Location AMC), University of Amsterdam, Amsterdam, The Netherlands., Stampalija T; Unit of Fetal Medicine and Prenatal Diagnosis, Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy.; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy., Lees C; Institute for Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, UK.; Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London W12 0HS.; Department of Gynecology and Obstetrics, UZ Leuven and Department of Regeneration and Development, KU Leuven, Leuven, Belgium., Arabin B; Department of Obstetrics Charite, Humboldt University Berlin and Clara Angela Foundation, Berlin, Germany., Berger A; Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria., Bergman E; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden., Bhide A; Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust and Molecular & Clinical Sciences Research Institute, St George's, University of London, London, UK., Bilardo CM; Department of Obstetrics and Gynecology, Amsterdam University Medical Centers, University of Amsterdam, location VUMC, Amsterdam, The Netherlands., Breeze AC; Fetal Medicine Unit, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, UK., Brodszki J; Department of Pediatric Surgery and Neonatology, Lund University, Skane University Hospital, Lund, Sweden., Calda P; Department of Obstetrics and Gynaecology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic., Cetin I; Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy., Cesari E; Department of Obstetrics and Gynecology, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy., Derks J; Department of Perinatal Medicine, University of Utrecht, Utrecht, The Netherlands., Ebbing C; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway., Ferrazzi E; Department of Obstetrics and Gynecology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy., Ganzevoort W; Department of Obstetrics and Gynecology, Amsterdam University Medical Center (Location AMC), University of Amsterdam, Amsterdam, The Netherlands., Frusca T; Department of Obstetrics and Gynecology, University of Parma, Parma, Italy., Gordijn SJ; Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Gyselaers W; Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Diepenbeek, Belgium, Department of Obstetrics & Gynaecology, Ziekenhuis Oost-Limburg, Genk and Department Physiology, Hasselt University, Diepenbeek, Belgium., Hecher K; Department of Obstetrics and Fetal Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany., Klaritsch P; Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria., Krofta L; Institute for the Care of Mother and Child, Prague, Czech Republic and Third Medical Faculty, Charles University, Prague, Czech Republic., Lindgren P; Center for Fetal Medicine, Karolinska University Hospital, Stockholm, Sweden., Lobmaier SM; Department of Obstetrics and Gynecology, Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany., Marlow N; UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK., Maruotti GM; Department of Neurosciences, Reproductive and Dentistry Sciences, University of Naples 'Federico II', Naples, Italy., Mecacci F; Department of Health Sciences, University of Florence, Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy., Myklestad K; St Olav's Hospital, Trondheim, Norway., Napolitano R; UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK.; Fetal Medicine Unit, University College London Hospitals NHS Foundation Trust, London, UK., Prefumo F; Department of Obstetrics and Gynecology, ASST Spedali Civili di Brescia and University of Brescia, Brescia, Italy., Raio L; Department of Obstetrics & Gynecology, University Hospital of Bern, Bern, Switzerland., Richter J; Department of Gynecology and Obstetrics, UZ Leuven and Department of Regeneration and Development, KU Leuven, Leuven, Belgium., Sande RK; Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger and Department of Clinical Science, University of Bergen, Bergen, Norway., Thornton J; School of Clinical Sciences, University of Nottingham, Division of Obstetrics and Gynaecology, Maternity Department, City Hospital, Nottingham, UK., Valensise H; Department of Surgery, Division of Obstetrics and Gynecology, Tor Vergata, University, Policlinico Casilino Hospital, Rome, Italy., Visser GHA; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway., Wee L; The Princess Alexandra Hospital NHS Trust, Harlow, UK.
Jazyk:	angličtina
Zdroj:	Ultraschall in der Medizin (Stuttgart, Germany : 1980) [Ultraschall Med] 2023 Feb; Vol. 44 (1), pp. 56-67. Date of Electronic Publication: 2021 Nov 12.
DOI:	10.1055/a-1511-8293
Abstrakt:	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] < 10 th 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. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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