Intrauterine growth restriction and absent or reverse end-diastolic blood flow in umbilical artery (Doppler class II or III): A retrospective study of short- and long-term fetal morbidity and mortality.

Details

Serval ID
serval:BIB_621991A07462
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Intrauterine growth restriction and absent or reverse end-diastolic blood flow in umbilical artery (Doppler class II or III): A retrospective study of short- and long-term fetal morbidity and mortality.
Journal
European journal of obstetrics, gynecology, and reproductive biology
Author(s)
Gerber S., Hohlfeld P., Viquerat F., Tolsa J.F., Vial Y.
ISSN
0301-2115
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
126
Number
1
Pages
20-6
Language
english
Notes
Publication types: Journal Article - Publication Status: ppublish
Abstract
OBJECTIVE: Absent or reverse end-diastolic flow (Doppler II/III) in umbilical artery is correlated with poor perinatal outcome, particularly in intrauterine growth restricted (IUGR) fetuses. The optimal timing of delivery is still controversial. We studied the short- and long-term morbidity and mortality among these children associated with our defined management. STUDY DESIGN: Sixty-nine IUGR fetuses with umbilical Doppler II/III were divided into three groups; Group 1, severe early IUGR, no therapeutic intervention (n = 7); Group 2, fetuses with pathological biophysical profile, immediate delivery (n = 35); Group 3, fetuses for which expectant management had been decided (n = 27). RESULTS: In Group 1, stillbirth was observed after a mean delay of 6.3 days. Group 2 delivered at an average of 31.6 weeks and two died in the neonatal period (6%). In Group 3 after a mean delay of 8 days, average gestational age at delivery was 31.7 weeks; two intra uterine and four perinatal deaths were observed (22%). Long-term follow-up revealed no sequelae in 25/31 (81%) and 15/18 (83%), and major handicap occurred in 1 (3%) and 2 patients (11%), respectively, for Groups 2 and 3. CONCLUSION: Fetal mortality was observed in 22% of this high risk group. After a mean period of follow-up of 5 years, 82% of infants showed no sequelae. According to our management, IUGR associated with umbilical Doppler II or III does not show any benefit from an expectant management in term of long-term morbidity.
Keywords
Adult, Blood Flow Velocity, Diastole, Female, Fetal Death, Fetal Growth Retardation, Fetus, Humans, Infant Mortality, Infant, Newborn, Pregnancy, Pregnancy Outcome, Regional Blood Flow, Retrospective Studies, Risk Factors, Ultrasonography, Doppler, Ultrasonography, Prenatal, Umbilical Arteries
Pubmed
Web of science
Create date
25/01/2008 12:12
Last modification date
20/08/2019 15:19
Usage data