Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction
| Autor: | Enery Gómez-Montes, M.S. Quezada, Elisa Simón, P.I. Gómez-Arriaga, Cecilia Villalain, Alberto Galindo, Ignacio Herraiz |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Middle Cerebral Artery medicine.medical_treatment Placenta Pregnancy Trimester Third Late onset Aorta Thoracic Ultrasonography Prenatal Umbilical Arteries 03 medical and health sciences 0302 clinical medicine Fetus Predictive Value of Tests Pregnancy medicine.artery medicine Humans 030212 general & internal medicine Labor Induced 030219 obstetrics & reproductive medicine Fetal Growth Retardation Vaginal delivery Obstetrics business.industry Cesarean Section Obstetrics and Gynecology Retrospective cohort study Ultrasonography Doppler Blood flow Fetal Weight Spain Labor induction Pediatrics Perinatology and Child Health Middle cerebral artery Gestation Female business |
| Zdroj: | Journal of perinatal medicineReferences. 47(2) |
| ISSN: | 1619-3997 |
| Popis: | Background As conflicting results have been reported about the association of reversed flow on the aortic isthmus (AoI) and adverse perinatal results in fetal growth restriction (FGR), we aim to compare perinatal outcomes (including tolerance to labor induction) of late-onset FGR between those with anterograde and reversed AoI flow. Methods This was an observational retrospective cohort study on 148 singleton gestations diagnosed with late-onset FGR (diagnosis ≥32+0 weeks), with an estimated fetal weight (EFW) th centile and mild fetal Doppler alteration: umbilical artery (UA) pulsatility index (PI) >95th centile, middle cerebral artery (MCA)-PI th centile or cerebral-placental ratio th centile. Anterograde AoI flow was present in n=79 and reversed AoI flow in n=69. Delivery was recommended from 37 weeks in both groups. Perinatal results were compared between the groups. Results The global percentage of vaginal delivery of fetuses with anterograde and reversed blood flow was 55.7% vs. 66.7% (P=0.18) and the percentage of cesarean section (C-section) for non-reassuring fetal status was 12.7% vs. 15.9% (P=0.29), respectively. When evaluating those that underwent labor induction, the vaginal delivery rate was 67.9% vs. 77.2% (P=0.17), respectively. There were no significant differences regarding any other perinatal variables and there were no cases of severe morbidity or mortality. Conclusion We observed that the presence of reversed AoI flow does not worsen perinatal outcomes on fetuses with late-onset growth restriction with mild Doppler alterations. Attempt of labor induction is feasible in these fetuses regardless of the direction of AoI flow. |
| Databáze: | OpenAIRE |
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