Prediction of acidemia at birth by Doppler assessment of fetal cerebral transverse sinus in pregnancies with placental insufficiency
| Autor: | Maria Regina Torloni, E. Araujo Junior, R. M. Santana, Antonio Fernandes Moron, Maurício Mendes Barbosa, L. M. M. Nardozza, Francisco Herlânio Costa Carvalho |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Population Diastole Placental insufficiency Umbilical cord Ultrasonography Prenatal Young Adult Pregnancy Positive predicative value medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies education education.field_of_study Fetus Radiological and Ultrasound Technology business.industry Obstetrics nutritional and metabolic diseases Obstetrics and Gynecology General Medicine Cerebral Arteries Laser Doppler velocimetry Placental Insufficiency medicine.disease Fetal Diseases Cross-Sectional Studies medicine.anatomical_structure ROC Curve Reproductive Medicine Ultrasonography Doppler Pulsed Cerebrovascular Circulation Pulsatile Flow Gestation Female Acidosis business Blood Flow Velocity |
| Zdroj: | Ultrasound in Obstetrics and Gynecology. 33:188-192 |
| ISSN: | 1469-0705 0960-7692 |
| DOI: | 10.1002/uog.6130 |
| Popis: | Objectives To evaluate the prediction of acidemia at birth using cerebral transverse sinus (CTS) Doppler velocimetry and to determine the best parameter and cut-off values for its prediction in pregnancies complicated with placental insufficiency. Methods This was a prospective cross-sectional study involving 69 pregnant women (26–40 weeks' gestation) with placental insufficiency managed in two Brazilian hospitals. Doppler assessment of the CTS was carried out in the last 24 h before delivery, and the peak ventricular systolic (S-wave) and diastolic (D-wave) velocities as well as the atrial systolic velocity (A-wave) were recorded and the pulsatility index for veins (PIV) was calculated. At birth, arterial and venous umbilical cord blood samples were collected to determine acid–base and pH status. A receiver–operating characteristics (ROC) curve was constructed for each Doppler parameter with birth acidemia as the dependent variable. Sensitivity, specificity, positive and negative predictive values, accuracy and false-positive and false-negative rates were calculated for the parameters considered to be good predictors of acidemia. Results The S, D and A peak velocities and the S/A ratio were not good predictors of acidemia at birth. The PIV and the (S − A)/S ratio were good predictors of acidemia (area under the ROC curve = 0.698 (P = 0.009) and 0.654 (P = 0.009), respectively). The cut-off values were PIV = 0.855 and (S − A)/S = 0.703). Conclusions The PIV and the (S − A)/S ratio of the CTS were good predictors of acidemia at birth in this high-risk population with placental insufficiency. Copyright © 2008 ISUOG. Published by John Wiley & Sons, Ltd. |
| Databáze: | OpenAIRE |
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