Longitudinal growth assessment for prediction of adverse perinatal outcome in fetuses suspected to be small-for-gestational age

Autor: Javier Caradeux, Elisenda Eixarch, Eduard Gratacós, E. Mazarico, Francesc Figueras, Tri Rahmat Basuki
Rok vydání: 2017
Předmět:
Adult
medicine.medical_specialty
Perinatal outcome
Gestational Age
longitudinal growth
Ultrasonography
Prenatal
03 medical and health sciences
fetal growth
0302 clinical medicine
Predictive Value of Tests
Pregnancy
medicine
Fetal growth
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Fetus
Univariate analysis
030219 obstetrics & reproductive medicine
fetal growth restriction
Fetal Growth Retardation
Radiological and Ultrasound Technology
Singleton
Obstetrics
business.industry
Longitudinal growth
adverse perinatal outcome
Infant
Newborn
Obstetrics and Gynecology
Ultrasonography
Doppler
General Medicine
medicine.disease
ultrasound
Uterine Artery
Reproductive Medicine
Fetal Weight
Infant
Small for Gestational Age
Multivariate Analysis
Small for gestational age
Female
business
Zdroj: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname
ULTRASOUND IN OBSTETRICS & GYNECOLOGY
r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
Fundació Sant Joan de Déu
ISSN: 1469-0705
0960-7692
Popis: OBJECTIVE: Fetal growth restriction (FGR) is associated with an increased risk of adverse perinatal outcome. However, distinguishing this condition from small-for-gestational age (SGA) remains elusive. A set of criteria has been proposed recently for such a purpose, including the degree of smallness, Doppler parameters and growth velocity. The aim of this study was to establish whether the use of growth velocity adds value to Doppler assessment in predicting adverse perinatal outcome among SGA-suspected fetuses. METHODS: This was a prospective cohort study of consecutive singleton pregnancies with late (diagnosis = 32.0 weeks) SGA (estimated fetal weight (EFW) < 10(th) centile). Longitudinal growth assessment was performed by calculation of EFW z-velocity between diagnosis and last scan before delivery. Improvement in the association with and predictive performance of EFW z-velocity for adverse perinatal outcome was compared against standard criteria of FGR evaluated before delivery (EFW < 3(rd) centile, abnormal uterine Doppler or abnormal cerebroplacental ratio). RESULT: A total of 472 patients were evaluated prospectively for suspected SGA. Of these, 231 (48.9%) qualified as late FGR. Univariate analysis showed a significant trend towards higher frequency (14.5% vs 8.2%; P = 0.041) of EFW z-velocity in the lowest decile in pregnancies with adverse perinatal outcome. Nonetheless, the addition of EFW z-velocity improved neither the association with nor the predictive performance of standard criteria of FGR for adverse perinatal outcome. CONCLUSIONS: Longitudinal assessment of fetal growth by means of EFW z-velocity did not have any independent predictive value for adverse perinatal outcome when used in combination with Doppler in SGA-suspected fetuses. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
Databáze: OpenAIRE
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