Umbilical artery Doppler velocimetry in predicting the perinatal outcomes in small for gestational age infants

OBJECTIVE: The aim of this study is to evaluate the effectiveness of the umbilical artery Doppler velocimetry in predicting perinatal outcome of small for gestational age (SGA) infants. MATERIALS AND METHODS: During from Sep. 1995 to Feb. 2006, we retrospectively studied 422 singleton pregnancies with a diagnosis of SGA at delivery, who had no chromosomal abnormalities or major structural anomalies in antenatal ultrasound, in Ajou University hospital. From this population, three subgroups were formed: normal umbilical artery systolic/ diastolic ratio (UASD); UASD ≥ 3.0 ; absent or reverse end-diastolic flow (A/REDF). The maternal characteristics and perinatal outcomes were compared between each groups. RESULTS: No differences in maternal age and parity were observed. In each groups, the mean gestational age at delivery were 37.3 ± 2.8, 36.0 ± 2.3, 32.4 ± 2.8 weeks (p<0.001), and the mean neonatal birth weight were 2311.6 ± 371.3, 1963.1 ± 402.7, 1168.9 ± 413.6 gm (p<0.001). The incidences of oligohydramnios were 12.4%, 17.7%, 33.3% (p=0.005), and the cesarean section rate for fetal distress were 13.7%, 23.9%, 50.0% (p=0.002). A statistically significant difference in the incidences of admission to NICU was found between the groups (41.0%, 81.2%, 100%; p<0.001). The rate of Apgar score at 5 min< 7 were 4.5%, 8.3%, 38.8% (p<0.001), and the interval from last Doppler to delivery were 7.1 ± 8.1, 4.8 ± 4.8, 3.8 ± 3.2 days (p=0.002). The incidences of averse neonatal outcome were 5.1%, 13.5%, 61.1% (p<0.001), when the definition of adverse neonatal outcomes was one or more of the followings: periventricular leukomalacia (PVL), intraventricular hemorrhage (IVH, > grade 2), necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), respiratory distress syndrome (RDS) and perinatal death. The logistic regression showed UASD a statistically significant risk factor in predicting the adverse neonatal outcomes (Odds ratio 2.4; 95% CI 1.2-5.6). CONCLUSIONS: SGA infants with normal UA Doppler flow showed better perinatal outcome than those with abnormal flow. Therefore, we suggest that SGA fetus with normal UA S/D may be had a different antenatal counselling, surveillence tests, and the time of delivery compared with those with abnormal flow.

Author dc:creator

• 문, 세희

Contributors dc:contributor

• 김, 행수
• 대학원 의학과
• 200424178

• 자궁내 태아발육제한
• 제대동맥 도플러 파형
• 주산기 예후
• 혈류속도
• 단태임신

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000001921
000000001921

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1628