Umbilical Artery Doppler Indices at the Perivesical Segment in Growth-Restricted Fetuses
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ORIGINAL ARTICLE
Umbilical Artery Doppler Indices at the Perivesical Segment in Growth-Restricted Fetuses Bas¸ ak Kaya1
•
Alev Atis¸ Aydin2
Received: 17 November 2019 / Accepted: 3 June 2020 Ó Society of Fetal Medicine 2020
Abstract To compare perinatal outcomes of growth-restricted fetuses with bilateral positive end-diastolic (PED) flow at the perivesical segment (PVC) and growth-restricted fetuses with unilateral or bilateral absent/reverse end-diastolic (ARED) flow at the PVC segment. A total of 119 growth-restricted fetuses with PED flow at the free loop of the umbilical artery were enrolled in this crosssectional study. Methods The patients were separated into three groups according to presence or absence of the enddiastolic flow at the perivesical segment. Patients with bilateral PED flow at the PVC segment were enrolled in Group1, patients with unilateral and bilateral (ARED) flow at the PVC segment were enrolled in Group 2 and 3, respectively. The perinatal outcomes of the groups were investigated. There were no significant differences between groups in terms of maternal age, gravida, parity, the gestational age at ultrasound examination and the pulsatility index of free umbilical artery. The gestational age at delivery, the birth weight and the interval between the diagnosis and delivery were found significantly higher in Group 1 than the other groups, there were no significant differences between Group 2 and 3 in terms of these Alev Atis¸ Aydin: contributing author. & Bas¸ ak Kaya [email protected] Alev Atis¸ Aydin [email protected] 1
Department of Maternal-Fetal Medicine, ˙Istanbul Medipol University Hospital, TEM Avrupa Otoyolu Go¨ztepe c¸ıkıs¸ ı No:1 Bag˘cılar, 34214 ˙Istanbul, Turkey
2
Department of Maternal-Fetal Medicine, Kanuni Sultan Su¨leyman Education and Research Hospital, Health Sciences University, 34303 ˙Istanbul, Turkey
parameters. More adverse pregnancy outcomes were observed in the unilateral and bilateral ARED flow groups than the bilateral PED flow group. In addition to the free loop Doppler indices, measuring the umbilical arteries Doppler indices at the PVC segment could contribute to the determination of more growth-restricted fetuses at risk of hypoxia. Keywords Fetal growth restriction Umbilical artery doppler Perivesical segment Absent/reversed enddiastolic flow
Introduction The evaluation of high-risk pregnancies with umbilical artery Doppler ultrasound reduces the risk of perinatal death without increasing obstetric interventions [1]. Umbilical artery Doppler velocimetry has been used to assess the vascular resistance noninvasively and accepted as a useful technique for fetal surveillance in pregnancies complicated with fetal growth restriction (FGR) due to uteroplacental insufficiency [2] and has been associated with improved perinatal outcomes in growth-restricted fetus [3, 4]. The umbilical artery Doppler waveform can be influenced by gestational age, fetal heart rate, fetal breathing and fetal movements. The site of measurement, the angle of insonation
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