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Cited by 166Pregnancy and preeclampsia studiesCardiovascular Conditions and TreatmentsNeonatal and fetal brain pathology

Qualitative venous Doppler waveform analysis improves prediction of critical perinatal outcomes in premature growth-restricted fetuses

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Baschat, A. A., Gembruch, U., Weiner, C. P., Harman, C. R.·2003·Ultrasound in Obstetrics & Gynecology
DOI 10.1002/uog.149
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Abstract

Background: Our aim was to test the hypothesis that qualitative ductus venosus and umbilical venous Doppler analysis improves prediction of critical perinatal outcomes in preterm growth‐restricted fetuses with abnormal placental function. Methods: Patients with suspected intrauterine growth restriction (IUGR) underwent uniform fetal assessment including umbilical artery (UA), ductus venosus (DV) and umbilical vein (UV) Doppler. Absent or reversed UA end‐diastolic velocity (UA‐AREDV), absence or reversal of atrial systolic blood flow velocity in the DV (DV‐RAV) and pulsatile flow in the umbilical vein (P‐UV) were examined for their efficacy to predict critical outcomes (stillbirth, neonatal death, perinatal death, acidemia and birth asphyxia) before 37 weeks' gestation. Results: Seventeen (7.6%) stillbirths and 16 (7.1%) neonatal deaths were observed among 224 IUGR fetuses. Forty‐one neonates were acidemic (19.8%) and seven (3.1%) had birth asphyxia. Logistic regression showed that UA‐AREDV had the strongest association with perinatal mortality ( R 2 = 0.49, P < 0.001), stillbirth ( R 2 = 0.48, P < 0.001) and acidemia ( R 2 = 0.22, P = 0.002) while neonatal death was most strongly related to DV‐RAV and P‐UV ( R 2 = 0.33, P = 0.007). UA waveform analysis offered the highest sensitivity and negative predictive value and DV‐RAV and P‐UV had the best specificity and positive predictive values for outcome prediction. Overall, DV‐RAV or P‐UV offered the best prediction of acidemia and neonatal and perinatal death irrespective of the UA waveform. In fetuses with UA‐AREDV, prediction of asphyxia and stillbirth was significantly enhanced by venous Doppler. Conclusion: Prediction of critical perinatal outcomes is improved when venous and umbilical artery qualitative waveform analysis is combined. The incorporation of venous Doppler into fetal surveillance is therefore strongly suggested for all preterm IUGR fetuses. Copyright © 2003 ISUOG. Published by John Wiley & Sons, Ltd.

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  • After 32 weeks of gestation, abnormal CTG findings will almost invariably precede Doppler abnormalities of the ductus venosus.

    “After 32 weeks of gestation, abnormal CTG findings will almost invariably precede Doppler abnormalities of the ductus venosus.111”

    From Society for Maternal-Fetal Medicine Consult Series #52: Diagnosis and management of fetal growth restriction (2020) · cites this paper as [111]

    The Discussion (page unavailable) describes cardiotocography as complementary to Doppler surveillance, but does not say which finding occurs first. A search for “32 weeks” found no gestational-age-specific comparison, so our copy does not verify the claimed sequence after 32 weeks. (LLM, conf=0.75)

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Research works printed but not linked: 2

  1. [13]13. Copyright  2003 ISUOG. Published by John Wiley & Sons, Ltd. Ultrasound Obstet Gynecol 2003; 22: 240-245. 14690705, 2003, 3, Downloaded from https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.149, Wiley Online Library on [02/12/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
  2. [28]28. Baschat AA, Gembruch U, Weiner CP, Harman CR. Combin- ing Doppler and biophysical assessment improves prediction of critical perinatal outcomes. Am J Obstet Gynecol 2002; 187: S147. Copyright  2003 ISUOG. Published by John Wiley & Sons, Ltd. Ultrasound Obstet Gynecol 2003; 22: 240-245. 14690705, 2003, 3, Downloaded from https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.149, Wiley Online Library on [02/12/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

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Authors
Baschat, A. A., Gembruch, U., Weiner, C. P., & Harman, C. R.
Affiliations
  • University of Maryland, Baltimore (US)
  • University of Bonn (DE)
Corresponding author
Baschat, A. A.
ORCID
Venue
Ultrasound in Obstetrics & Gynecology
Publisher
Wiley
Published
2003-08-13
Volume
22
Issue
3
Pages
240-245
ISSN
  • 0960-7692 (ISSN-L)
  • 1469-0705
DOI
10.1002/uog.149
OpenAlex
W2164014714
Semantic Scholar
0cffb5e746c7a360d68044f18f27a4f04e82e393
Cited by
166
References
27
Citations by year
2026: 6 · 2025: 7 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 3 · 2018: 8 · 2017: 9 · 2016: 9 · 2015: 6 · 2014: 7 · 2013: 7 · 2012: 16
FWCI
7.26
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Ultrasound in Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
Keywords
fetal growth restriction, ductus venosus Doppler, umbilical artery Doppler, fetal acidemia, neonatal asphyxia, stillbirth, perinatal mortality, neonatal death, placental insufficiency, preterm fetuses, Doppler waveform analysis, fetal monitoring
MeSH terms
Asphyxia Neonatorum, Blood Flow Velocity, Female, Fetal Death, Fetal Distress, Fetal Growth Retardation, Humans, Infant, Newborn, Infant, Premature, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Regression Analysis, Umbilical Arteries, Umbilical Veins, Logistic Models, Ultrasonography, Prenatal, Ultrasonography, Doppler

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