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Published in: The Journal of Obstetrics and Gynecology of India 1/2016

01-10-2016 | Original Article

Which is Superior, Doppler Velocimetry or Non-stress Test or Both in Predicting the Perinatal Outcome of High-Risk Pregnancies

Authors: Vijaya Subramanian, Janani Venkat, Mohana Dhanapal

Published in: The Journal of Obstetrics and Gynecology of India | Special Issue 1/2016

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Abstract

Aim and Objectives

To analyze which is superior, Doppler velocimetry or non-stress test or both by means of categorization into four groups and comparing the prediction of perinatal outcome in high-risk pregnancies like anemia, hypertensive disorders of pregnancies.

Materials and Methods

This was a prospective study conducted at the Department of Obstetrics and Gynaecology, ISO KGH, Madras Medical College, Chennai, in the year 2014. Two hundred high-risk pregnancies like anemia, hypertensive disorders of pregnancy were included in the study. They were examined systematically, and Doppler velocimetry and non-stress test were done. The main vessels studied by Doppler were umbilical artery and middle cerebral artery, and the indices were calculated. The results of the non-stress test were interpreted as reactive and non-reactive. Based on the results of Doppler and non-stress test, the 200 cases were categorized into four groups and the results were analyzed.

Results

Among the 200 cases of high-risk pregnancies, those with a normal Doppler study and a reactive non-stress test had good perinatal outcome. When both were abnormal, there was a higher percentage of adverse outcome as compared to that of either Doppler alone being abnormal or non-stress test alone being non-reactive. It was also found that abnormal Doppler but with a reactive non-stress test had the advantage of prolonging the pregnancy and bringing a better outcome indicating that non-stress test is surely a good test of well-being. When Doppler was normal, but non-stress test was non-reactive, there was an increase in the rate of cesarean section.

Conclusion

Each method of fetal surveillance reflects different aspect of maternal and fetal pathophysiology. Hence, combining these will help to bring out better perinatal outcome.
Literature
1.
go back to reference Maulik D, Yarlagadda P, Downing G. Doppler velocimetry in obstetrics. Obstet Gynecol Clin N Am. 1990;17:163–86. Maulik D, Yarlagadda P, Downing G. Doppler velocimetry in obstetrics. Obstet Gynecol Clin N Am. 1990;17:163–86.
2.
go back to reference Maulik D. Basic principles of Doppler ultrasound as applied in obstetrics. Clin Obstet Gynecol. 1989;32:628–44.CrossRefPubMed Maulik D. Basic principles of Doppler ultrasound as applied in obstetrics. Clin Obstet Gynecol. 1989;32:628–44.CrossRefPubMed
3.
go back to reference Giles WB, Trudinger BJ, Baird PJ. Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation. Br J Obstet Gynaecol. 1985;92:31–8.CrossRefPubMed Giles WB, Trudinger BJ, Baird PJ. Fetal umbilical artery flow velocity waveforms and placental resistance: pathological correlation. Br J Obstet Gynaecol. 1985;92:31–8.CrossRefPubMed
4.
go back to reference Vyas S, Nicolaides KH, Bower S, et al. Middle cerebral artery flow velocity waveforms in fetal hypoxaemia. Br J Obstet Gynaecol. 1990;97:797–803.CrossRefPubMed Vyas S, Nicolaides KH, Bower S, et al. Middle cerebral artery flow velocity waveforms in fetal hypoxaemia. Br J Obstet Gynaecol. 1990;97:797–803.CrossRefPubMed
5.
go back to reference Burns PN. Doppler flow estimations in the fetal and maternal circulations: principles, techniques and some limitations. In: Maulik D, McNellis D, editors. Doppler ultrasound measurement of maternal-fetal hemodynamics. Ithaca: Perinatology Press; 1987. p. 43–78. Burns PN. Doppler flow estimations in the fetal and maternal circulations: principles, techniques and some limitations. In: Maulik D, McNellis D, editors. Doppler ultrasound measurement of maternal-fetal hemodynamics. Ithaca: Perinatology Press; 1987. p. 43–78.
6.
go back to reference Krebs HB, Petres RE. Clinical application of a scoring system for evaluation of antepartum fetal heart rate monitoring. Am J Obstet Gynecol. 1978;130:765.CrossRefPubMed Krebs HB, Petres RE. Clinical application of a scoring system for evaluation of antepartum fetal heart rate monitoring. Am J Obstet Gynecol. 1978;130:765.CrossRefPubMed
7.
go back to reference Lyons ER, Bylsma-Howell M, Siamsi S, et al. A scoring system for nonstressed antepartum fetal heart rate monitoring. Am J Obstet Gynecol. 1979;133:242.CrossRefPubMed Lyons ER, Bylsma-Howell M, Siamsi S, et al. A scoring system for nonstressed antepartum fetal heart rate monitoring. Am J Obstet Gynecol. 1979;133:242.CrossRefPubMed
8.
go back to reference Devoe LD, Yanowitch G, Azor H. The application of multiple-parameter scoring to antepartum fetal heart rate testing. J Reprod Med. 1981;26:250.PubMed Devoe LD, Yanowitch G, Azor H. The application of multiple-parameter scoring to antepartum fetal heart rate testing. J Reprod Med. 1981;26:250.PubMed
9.
go back to reference Pearson JF, Weayer JB. A six-point scoring system for antenatal cardiotocographs. Br J Obstet Gynaecol. 1978;85:321.CrossRefPubMed Pearson JF, Weayer JB. A six-point scoring system for antenatal cardiotocographs. Br J Obstet Gynaecol. 1978;85:321.CrossRefPubMed
10.
go back to reference Nathanielsz PW, Bailey A, Poore ER, et al. The relationship between myometrial activity and sleep state and breathing in fetal sheep throughout the last third of gestation. Am J Obstet Gynecol. 1980;138:653.CrossRefPubMed Nathanielsz PW, Bailey A, Poore ER, et al. The relationship between myometrial activity and sleep state and breathing in fetal sheep throughout the last third of gestation. Am J Obstet Gynecol. 1980;138:653.CrossRefPubMed
11.
go back to reference Powell OH, Melville A, MacKenna JL. Fetal heart rate acceleration in labor: excellent prognostic indicator. Am J Obstet Gynecol. 1979;134:36.CrossRefPubMed Powell OH, Melville A, MacKenna JL. Fetal heart rate acceleration in labor: excellent prognostic indicator. Am J Obstet Gynecol. 1979;134:36.CrossRefPubMed
12.
go back to reference Sharbaf FR, Amjadi N, Alavi A, et al. Normal and indeterminate pattern of fetal cardiotocography in admission test and pregnancy outcome. J Obstet Gynaecol Res. 2014;40(3):694–9.CrossRefPubMed Sharbaf FR, Amjadi N, Alavi A, et al. Normal and indeterminate pattern of fetal cardiotocography in admission test and pregnancy outcome. J Obstet Gynaecol Res. 2014;40(3):694–9.CrossRefPubMed
Metadata
Title
Which is Superior, Doppler Velocimetry or Non-stress Test or Both in Predicting the Perinatal Outcome of High-Risk Pregnancies
Authors
Vijaya Subramanian
Janani Venkat
Mohana Dhanapal
Publication date
01-10-2016
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue Special Issue 1/2016
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-015-0829-z

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