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Progression of Doppler changes in early-onset small for gestational age fetuses. How frequent are the different progression sequences?

Morales-Roselló, J; Khalil, A; Fornés-Ferrer, V; Alberola-Rubio, J; Hervas-Marín, D; Peralta Llorens, N; Perales-Marín, A (2017) Progression of Doppler changes in early-onset small for gestational age fetuses. How frequent are the different progression sequences? J Matern Fetal Neonatal Med, 31 (8). pp. 1000-1008. ISSN 1476-4954 https://doi.org/10.1080/14767058.2017.1304910
SGUL Authors: Khalil, Asma

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Abstract

OBJECTIVE: To evaluate the progression of Doppler abnormalities in early-onset fetal smallness (SGA). METHODS: A total of 948 Doppler examinations of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV), belonging to 405 early-onset SGA fetuses, were studied, evaluating the sequences of Doppler progression, the interval examination-labor at which Doppler became abnormal and the cumulative sum of Doppler anomalies in relation with labor proximity. RESULTS: The most frequent sequences were that in which only the UA pulsatility index (PI) became abnormal (42.1%) and that in which an abnormal UA PI appeared first, followed by an abnormal MCA PI (24.2%). In general, 71.3% of the fetuses followed the classical progression sequence UA→MCA→DV, mostly in the early stages of growth restriction (84.1%). In addition, the UA PI was the first parameter to be affected (9 weeks before delivery), followed by the MCA PI and the DV PIV (1 and 0 weeks). Finally, the UA PI began to sum anomalies 5 weeks before delivery, while the MCA and DV did it at 3 and 1 weeks before the pregnancy ended. CONCLUSIONS: In early-onset SGA fetuses, Doppler progression tends to follow a predictable order, with sequential changes in the umbilical, cerebral and DV impedances.

Item Type: Article
Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of Maternal-Fetal and Neonatal Medicine on 27/3/2017, available online: http://www.tandfonline.com/10.1080/14767058.2017.1304910
Keywords: Early-onset fetal growth restriction, ductus venosus, fetal hemodynamics, fetal middle cerebral artery, small-for-gestational-age, umbilical artery, Obstetrics & Reproductive Medicine, 1114 Paediatrics And Reproductive Medicine
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Matern Fetal Neonatal Med
ISSN: 1476-4954
Language: eng
Dates:
DateEvent
27 March 2017Published Online
7 March 2017Accepted
Publisher License: Publisher's own licence
PubMed ID: 28279117
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108882
Publisher's version: https://doi.org/10.1080/14767058.2017.1304910

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