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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 4/2019

01-04-2019 | Intrauterine Growth Restriction | Maternal-Fetal Medicine

Reference charts for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord

Authors: Elena Contro, Ilaria Cataneo, Danila Morano, Antonio Farina

Published in: Archives of Gynecology and Obstetrics | Issue 4/2019

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Abstract

Purpose

To determine reference values for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord and to compare these values with standard umbilical Doppler pulsatility index curves from 23 to 40 gestational weeks.

Methods

A retrospective longitudinal cohort study was conducted between January 2014 and December 2017 in a tertiary referral hospital and included 62 pregnant women with isolated single umbilical artery (two-vessel cord) and 174 measurements. Only uncomplicated term pregnancies were included. A reference curve for umbilical Doppler pulsatility index was built up and compared with a standard curve commonly used for fetuses with three-vessel cord.

Results

Umbilical Doppler pulsatility index values were much lower than expected in cases with two-vessel cord compared to 3-vessel cord: mean of the regression equations was 1.02 ± 0.23 vs. 0.86 ± 0.19, respectively (p value < 0.001). This difference was quite constant across the gestational weeks considered, showing that the slopes of the two regressions were very similar.

Conclusion

Reference curves for umbilical Doppler pulsatility index in two-vessel cord pregnancies were determined. Pulsatility index values were significantly different compared with those commonly used for three-vessel cord. Using lower reference values for umbilical pulsatility index in cases with two-vessel cord may allow a better identification of fetuses affected with intrauterine growth restriction, thus improving fetal surveillance.
Literature
1.
Parilla BV, Tamura RK, MacGregor SN, Geibel LJ, Sabbagha RE (1995) The clinical significance of a single umbilical artery as an isolated finding on prenatal ultrasound. Obstet Gynecol. 85:570–572CrossRefPubMed
2.
Hua M, Odibo AO, Macones GA, Roehl KA, Crane JP, Cahill AG, et al (2010) Single umbilical artery and its associated findings. Obstet Gynecol 115:930–934.
3.
Martínez-Payo C, Cabezas E, Nieto Y, Azúa MRd, García-Benasach F, Iglesias E (v) Detection of single umbilical artery in the first trimester ultrasound: its value as a marker of fetal malformation. Biomed Res Int
4.
ISUOG Practice Guidelines: performance of first-trimester fetal ultrasound scan UOG, vol 41 n, pp 102–113, 2013.
5.
Lamberty CO, de Carvalho MHB, Miguelez J, Liao AW, Zugaib M (2011) Ultrasound detection rate of single umbilical artery in the first trimester of pregnancy. Prenat Diagn 31(9):865–868.
6.
Jacques SA, Steven LW, David MS, Levy DL, Woods JR (1991) Value of a random single Doppler study of the umbilical artery for predicting perinatal outcome. J Ultrasound Med 10(6):337-339.
7.
Pierce BT, Dance V, Wagner RK, Apodaca CC, Nielsen PE, Calhoun BC (2001) Perinatal outcome following fetal single umbilical artery diagnosis. J Matern Fetal Med 10:59–63CrossRefPubMed
8.
Murphy-Kaulbeck L, Doods L, Joseph KS, van den Hof M (2010) Single umbilical artery risk factors and pregnancy outcomes.Obstetr Gynecol 116(4):843–850.
9.
Catanzarite VA, Hendricks S, Maida C, Westbrook C, Cousins L, Schrimmer D (1995) Prenatal diagnosis of the two-vessel cord: implications for patient counselling and obstetric management. Ultrasound Obstet Gynecol 5:98–105CrossRefPubMed
10.
Voskamp BJ, Fleurke-Rozema H, Oude-Rengerink K et al (2013) Relationship of isolated single umbilical artery to fetal growth, aneuploidy and perinatal mortality: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 42(6):622–628CrossRefPubMed
11.
Sterne GSL, Dubinsky TJ (2001) Abnormal fetal cerebral andumbilical Doppler measurements in fetuses with intrauterine growth restriction predicts the severity of perinatal morbidity.J Clin Ultrasound 29:146–151.
12.
Chang CH, Chang F, Yu CH, Liang RI, Ko HC, Chen HY (2000) Systemic assessment of fetal hemodynamics by Doppler ultrasound. Ultrasound Med Biol 26:777–785CrossRefPubMed
13.
Gornall AS, Kurinczuk JJ, Konje JC (2003) Antenatal detection of a single umbilical artery: does it matter? Prenat Diagn 23:117–123.
14.
Joel B, Adi YW, Yael S, Salvatore AM, Speigel E, Hershkovitz R (2015) Umbilical artery blood flows among pregnancies with single umbilical artery: a prospective casecontrol study. J Matern Fetal Neonatal Med 28(15):1803–1805.
15.
Goldkrand JW, Pettigrew C, Lentz SU et al (2001) Volumetric umbilical artery blood flow: comparison of the normal versus the single umbilical artery cord. J Matern Fetal Med 10:116–121.
16.
Hershkovitz R, Sheiner E, Mazor M (2006) Middle cerebral artery blood flow velocimetry among healthy fetuses with a single umbilical artery. J Ultrasound Med 25:1405–1408.
17.
Sepulveda W, Peek MJ, Hassan J et al (1996) Umbilical vein to artery ratio in fetuses with single umbilical artery. Ultrasound Obstet Gynecol 8:23–26.
18.
Acharya G, Wilsgaard T, Berntsen GK, Maltau JM, Kiserud T(2005) Reference ranges for serial measurements of blood velocity and pulsatility index at the intra-abdominal portion, and fetal and placental ends of the umbilical artery. Ultrasound Obstet Gynecol 26(2):162–169.
19.
Glantz SA, Slinker BK (1990) Primer of applied regression and analysis of variance 1st edition
Metadata
Title
Reference charts for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord
Authors
Elena Contro
Ilaria Cataneo
Danila Morano
Antonio Farina
Publication date
01-04-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 4/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-019-05086-z

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