Comparison Doppler evaluation and relationship between of umbical artery flow and the ductus venosus waveform in the prediction of adverse perinatal outcome in growth - restricted fetuses

Abstract

Objective: To compare Doppler evaluation of the ductus venosus and umblitical artery for the prediction of adverse perinatal outcomes in growth-restricted fetuses with evidence of hemodynamic redistribution. Methods: A prospective study involving 252 patients were collected from all singleton pregnancies who underwent antenatal monitoring for fetal growth restriction treated in the National Hospital of Gynecology and Obstetrics from January 2011 to january 2015. Data were collected from all singleton pregnancies who underwent antenatal monitoring for fetal growth restriction and ductus venosus waveform results. Peri-natal outcome was evaluated by means of four variables: an umbilical artery, pH ≤ 7.15 and significant neonatal morbidity. Outcome was compared among fetuses delivered of their antenatal test. Logistic regression analysis was used to analyze the relation between predictive and outcome variables. Results: for the study, in IUGR fetuses, the predictive value for perinatal outcome of abnormal umblitical artery versus ductus venosus waveform with the sensitivity, spesifivity positive values, negative predictive values were 62.5%, 96.4%, 71.4%, 94.6% and 69.7%, 95.4%, 69.7%, 95.4%. 75.0%, 95.9%. The predictive value for perinatal outcome of abnormal umblitical artery and ductus venosus waveform were 75.0%, 95.9%,72.7%,96.3%. Conclusion: venous Doppler velocimetric signs of cardiac decompensation might predict fetal demise and the umbilical artery flow and venose Doppler evaluation might give valuable clinical information for surveillance in IUGR fetuses.