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2018 | 18 | 72 | 22–28
Article title

Utility of Doppler parameters at 36–42 weeks’ gestation in the prediction of adverse perinatal outcomes in appropriate-for-gestational-age fetuses

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PL
Przydatność parametrów dopplerowskich w 36.–42. tygodniu ciąży jako predyktorów nieprawidłowego stanu okołoporodowego u płodów z masą odpowiednią dla wieku ciążowego
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EN
Abstracts
EN
Aim: To investigate the potential value of Doppler ultrasound and to assess cerebroplacental ratio (CPR) in the prediction of adverse perinatal outcome defined as Apgar score < 7 at 1 minute. Material and methods: This was a retrospective cross-sectional study in selected pregnant women undergoing an ultrasound examination between 36 and 42 weeks of gestation. We measured estimated fetal weight (EFW), mean umbilical artery pulsatility index (UA PI), mean middle cerebral artery pulsatility index (MCA PI), CPR, and Apgar score in 1 minute. Multiples of medians (MoM) were calculated for MCA PI and UA PI. Results: The study group consisted of 446 women, 236 were primipara and 210 were multipara. The average age was 29.6 years (range 16–46 years). The average week of delivery is 39.5 weeks of gestation (range 36–42). Mean MCA PI and UA PI were 1.3 (0.1–2.45) and 0.8 (0.39–1.66), respectively. The mean values were 1.03 (0.1–1.9) for MCA PI MoM and 1.04 (0.5–2.1) for UA PI MoM. Primiparas had lower values of MCA PI (1.27 vs. 1.34), MCA PI MoM (1.00 vs. 1.05), CPR (1.62 vs. 1.73), EFW (3479.53 g vs. 3579.25 g) and birth weight (3513.50 g vs. 3617.79 g). For CPR cut-off point of 1.08: sensitivity was (0.945), specificity 0.1, positive predictive values 0.979, negative predictive values 0.04 and accuracy 0.926. The ROC curves for CPR were: area under the curve was 0.52 at CI 95% (0.342–0.698), p = 0.8271. Conclusion: Screening in pregnancies with appropriate-for-gestational-age fetuses at 36–42 weeks of gestation using Doppler parameters is not useful in the prediction of adverse perinatal outcomes like an Apgar score < 7 at 1 minute.
PL
Cel pracy: Zbadanie przydatności badania dopplerowskiego oraz współczynnika mózgowo-pępowinowego (CPR) w przewidywaniu powikłań okołoporodowych zdefiniowanych jako wynik w skali Apgar <7 punktów w 1. minucie po urodzeniu. Materiał i metody: Niniejsze badanie przekrojowe miało charakter retrospektywny. Objęło kobiety ciężarne poddawane badaniu USG pomiędzy 36. a 42. tygodniem ciąży. Rejestrowane parametry to: szacunkowa masa ciała płodu (EFW), średnia wartość wskaźnika pulsacji tętnicy pępowinowej (UA PI), średnia wartość wskaźnika pulsacji tętnicy środkowej mózgu (MCA PI), CPR oraz punktacja w skali Apgar w 1. minucie po urodzeniu. Obliczano też wielokrotności mediany (MoM) MCA PI oraz UA PI. Wyniki: Grupa objęta badaniem składała się łącznie z 446 kobiet, w tym 236 pierworódek oraz 210 wieloródek. Średnia wieku uczestniczek badania wynosiła 29,6 roku (zakres 16–46 lat). Średnia wieku ciążowego, w którym następowało rozwiązanie, wynosiła 39,5 tygodnia (zakres 36–42 tygodni). Średnie wartości MCA PI i UA PI wynosiły odpowiednio 1,3 (0,1–2,45) oraz 0,8 (0,39–1,66). Średnie wartości MoM wynosiły dla MCA PI 1,03 (0,5–2,1), a dla UA PI 1,04 (0,5–2,1). U pierworódek stwierdzono niższe wartości wskaźnika MCA PI (1,27 vs 1,34), MCA PI MoM (1,00 vs 1,05), CPR (1,62 vs 1,73), EFW (3479,53 g vs 3579,25 g) oraz urodzeniowej masy ciała (3513,50 g vs 3617,79 g). Dla CPR przy punkcie odcięcia równym 1,08 czułość wynosiła 0,945, swoistość 0,1, wartość predykcyjna dodatnia 0,979, wartość predykcyjna ujemna 0,04, dokładność 0,926. Krzywe ROC dla CPR kształtowały się następująco: pole pod krzywą wynosiło 0,52 przy 95-procentowym przedziale ufności (0,342–0,698), p = 0,8271. Wnioski: Badanie przesiewowe z wykorzystaniem parametrów dopplerowskich nie jest pomocne w przewidywaniu powikłań okołoporodowych, takich jak wynik Apgar <7 w 1. minucie po urodzeniu, w ciążach, w których masa ciała płodu odpowiada wiekowi ciążowemu pomiędzy 36. a 42. tygodniem ciąży. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/issues/volume-18-no-72
Discipline
Publisher

Year
Volume
18
Issue
72
Pages
22–28
Physical description
Contributors
author
  • Obstetrics, Women’s Disease and Gynecological Oncology Teaching Department, Voivodeship Hospital Complex, Collegium Medicum of the Nicolaus Copernicus University in Toruń, Poland; Civis Vita Medical Center in Toruń, Poland, mchmigda@gmail.com
  • Obstetrics, Women’s Disease and Gynecological Oncology Teaching Department, Voivodeship Hospital Complex, Collegium Medicum of the Nicolaus Copernicus University in Toruń, Poland
author
  • Diagnostic Imaging Division, Second Faculty of Medicine with the English Division and the Physiotherapy Division, Medical University of Warsaw, Warsaw, Poland
  • Civis Vita Medical Center in Toruń, Poland
  • Obstetrics, Women’s Disease and Gynecological Oncology Teaching Department, Voivodeship Hospital Complex, Collegium Medicum of the Nicolaus Copernicus University in Toruń, Poland
References
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Document Type
article
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YADDA identifier
bwmeta1.element.psjd-63202431-a351-4e9a-b95a-b11fdb5efa78
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