Amniotic-umbilical-to-cerebral ratio, a Doppler index for estimating adverse perinatal outcomes in fetal growth restriction

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2024-09-04 DOI:10.1002/jcu.23783

Zeynep Seyhanli MD, Burak Bayraktar MD, Gulsan Karabay MD, Recep Taha Agaoglu, Can Ozan Ulusoy MD, Gizem Aktemur MD, Betul Tokgoz Cakir MD, Mevlut Bucak MD, Kadriye Yakut Yucel

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引用次数: 0

Abstract

Objective

To evaluate amniotic fluid volume with Doppler parameters and its association with composite adverse perinatal outcomes (CAPOs) in fetal growth restriction (FGR).

Materials and Methods

This study was conducted prospectively in a tertiary referral center between 2023 and 2024 on pregnant women diagnosed with early- and late-onset FGR. Fetal ultrasonographic measurements, including deepest vertical pocket (DVP) for amniotic fluid, and Doppler parameters including uterine artery (UtA) systolic/diastolic (S/D) and pulsatility index (PI), middle cerebral artery (MCA) S/D and PI, and umbilical artery (UA) S/D and PI, were conducted following fetal biometry. The cerebroplacental ratio (CPR), cerebral ratio, cerebro-placental-uterine ratio (CPUR), and amniotic-umbilical-to-cerebral ratio (AUCR) were all calculated. Pregnant women diagnosed with FGR were planned to give birth after 37 weeks' gestation, unless a pregnancy complication requiring earlier delivery occurred. We assessed perinatal outcomes subsequent to delivery, with CAPOs defined as the presence of at least one adverse outcome: 5th minute APGAR score <7, respiratory distress syndrome (RDS), umbilical cord blood pH <7.2, and neonatal intensive care unit (NICU) admission.

Results

The study included 132 participants, divided into early- (n = 32) and late-onset FGR (n = 100) groups. AUCR was significantly lower in fetuses with late-onset FGR who experienced CAPOs. Multivariate analysis showed gestational age at birth and birth weight were significant predictors of CAPOs in early-onset FGR, while gestational age, birth weight, and AUCR were significant predictors in late-onset FGR. CPR, UCR, and CPUR did not show significance in predicting CAPOs in both early- and late-onset FGR on multivariate analysis.

Conclusions

AUCR is a potential reliable marker for predicting adverse perinatal outcomes in late-onset FGR.

Abstract Image

查看原文本刊更多论文

羊膜-脐-脑比率--用于估计胎儿生长受限围产期不良结局的多普勒指数。

摘要用多普勒参数评估羊水量及其与胎儿生长受限（FGR）围产期综合不良结局（CAPOs）的关系：本研究于 2023 年至 2024 年期间在一家三级转诊中心对确诊为早发型和晚发型 FGR 的孕妇进行了前瞻性研究。在进行胎儿生物测量后，进行了胎儿超声测量，包括羊水最深垂直袋（DVP）和多普勒参数，包括子宫动脉（UtA）收缩/舒张（S/D）和搏动指数（PI）、大脑中动脉（MCA）收缩/舒张（S/D）和PI、脐动脉（UA）收缩/舒张（S/D）和PI。还计算了脑-胎盘比值（CPR）、脑比值、脑-胎盘-子宫比值（CPUR）和羊膜-脐-脑比值（AUCR）。被诊断为 FGR 的孕妇计划在妊娠 37 周后分娩，除非出现需要提前分娩的妊娠并发症。我们对分娩后的围产期结果进行了评估，CAPO 的定义是至少出现一种不良结果：第 5 分钟 APGAR 评分结果：该研究包括 132 名参与者，分为早发 FGR 组（32 人）和晚发 FGR 组（100 人）。晚发 FGR 胎儿的 AUCR 明显低于经历过 CAPO 的胎儿。多变量分析显示，胎龄和出生体重是早发型FGR发生CAPO的重要预测因素，而胎龄、出生体重和AUCR则是晚发型FGR发生CAPO的重要预测因素。在多变量分析中，CPR、UCR和CPUR对预测早发和晚发FGR的CAPO均无显著意义：AUCR是预测晚发型FGR围产期不良结局的潜在可靠指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.