Fetal Outcomes Associated with the Sequence of Doppler Deterioration in Severely Growth‐Restricted Fetuses
| Autor: | Jun Sasahara, Ryo Yamamoto, Keisuke Ishii, Nobuaki Mitsuda, Takeshi Kanagawa |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Placenta Gestational Age Ultrasonography Prenatal Umbilical Arteries 030218 nuclear medicine & medical imaging 03 medical and health sciences symbols.namesake Fetus 0302 clinical medicine Pregnancy Internal medicine medicine.artery Humans Medicine Radiology Nuclear Medicine and imaging Retrospective Studies Fetal Growth Retardation 030219 obstetrics & reproductive medicine Radiological and Ultrasound Technology business.industry Infant Newborn Gestational age Ultrasonography Doppler Retrospective cohort study Umbilical artery Middle cerebral artery cardiovascular system Cardiology symbols Female Abnormality business Doppler effect Ductus venosus circulatory and respiratory physiology |
| Zdroj: | Journal of Ultrasound in Medicine. 40:2307-2315 |
| ISSN: | 1550-9613 0278-4297 |
| Popis: | Objectives Various patterns of Doppler deterioration exist in fetal growth restriction (FGR). However, the factors that differentiate these patterns are still unknown. The purpose of this study was to clarify the perinatal outcomes and factors to determine the pattern of Doppler deterioration in severe FGR. Materials and methods We conducted a retrospective cohort study of preterm severe FGR with Doppler abnormality, wherein the clinical features, including maternal characteristics, medical history, and sonographic findings, were compared between the patterns of Doppler deterioration. We used the multivariable logistic regression analyses to identify the factors associated with the pattern of Doppler deterioration. Results Of 322 eligible fetuses, 143 had Doppler abnormalities. Fetuses with Doppler deterioration from ductus venosus uniquely featured fetal and placental-umbilical abnormalities detected after birth. Gestational age (GA) at diagnosis of FGR and at the first diagnosis of Doppler abnormality in fetuses with Doppler deterioration from middle cerebral artery (MCA) were later than those from umbilical artery. In addition, the factor associated with Doppler deterioration from MCA was 31-week GA at the first diagnosis of Doppler abnormality (adjusted odds ratio [aOR]: 26.7; 95% CI: 8.35-103), not GA at diagnosis of FGR (aOR: 1.82; 95% CI: 0.50-5.96). Conclusions Characteristics of each Doppler deterioration pattern might reflect FGR etiology. Undetectable anomalies and umbilical-placental abnormalities were found in fetuses with Doppler deterioration from the ductus venosus. Doppler deterioration from the MCA was observed after 31 weeks of gestation not only in the late-onset FGR but also in the early-onset FGR with normal umbilical artery Doppler findings. |
| Databáze: | OpenAIRE |
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