Second-trimester prediction of delivery of a small-for-gestational-age neonate: integrating sequential Doppler information, fetal biometry, and maternal characteristics

被引:13
作者
Seravalli, Viola [1 ]
Block-Abraham, Dana M. [1 ]
Turan, Ozhan M. [1 ]
Doyle, Lauren E. [1 ]
Blitzer, Miriam G. [2 ]
Baschat, Ahmet A. [1 ]
机构
[1] Univ Maryland, Sch Med, Dept Obstet Gynecol & Reprod Sci, Baltimore, MD 21201 USA
[2] Univ Maryland, Sch Med, Dept Pediat, Baltimore, MD 21201 USA
关键词
UTERINE ARTERY DOPPLER; GROWTH RESTRICTION; TRANSVAGINAL UTERINE; BLOOD-FLOW; PREECLAMPSIA; PREGNANCY; INDEXES; DIAGNOSIS; FETUS; RISK;
D O I
10.1002/pd.4418
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
ObjectiveThe aim of this study was to investigate the predictive accuracy of second-trimester ultrasound parameters, maternal characteristics, and sequential Doppler changes between first and second trimesters for the prediction of small-for-gestational-age (SGA) infants (birth weight<10th percentile). MethodsWe conducted a prospective study of singleton pregnancies enrolled in the first trimester with subsequent second-trimester follow-up. Maternal characteristics, uterine artery (UtA) pulsatility index (PI), fetal biometry, and umbilical artery (UA)-PI were ascertained. UtA and UA-PI change from first to second trimester was calculated (UtA-PI and UA-PI). These parameters were tested for their ability to predict delivery of an SGA infant. ResultsAmong 1982 women, 172 delivered an SGA neonate. African-American ethnicity, nulliparity, tobacco use, and low abdominal circumference (AC) z-score were independent predictors of SGA. No difference was found in the magnitude of UtA-PI and UA-PI between SGA and no-SGA. Receiver-operating characteristics curve analysis yielded an area under the curve of 0.700 for AC z-score. The combination of low AC and bilateral notching had high specificity (99%) but low sensitivity (7%) for SGA prediction. ConclusionsA small second-trimester fetal AC is a specific marker for SGA when found with bilateral UtA notching. Only a small proportion is predicted by the factors studied, suggesting a small contributory role or later evolution of SGA. (c) 2014 John Wiley & Sons, Ltd.
引用
收藏
页码:1037 / 1043
页数:7
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[31]   Doppler ultrasound of umbilical and middle cerebral artery in third trimester small-for-gestational age fetuses to decide on timing of delivery for suspected fetal growth restriction: A cohort with nested RCT (DRIGITAT) [J].
Marijnen, Mauritia C. ;
Kamphof, Hester D. ;
Damhuis, Stefanie E. ;
Smies, Maddy ;
Leemhuis, Aleid G. ;
Wolf, Hans ;
Gordijn, Sanne J. ;
Ganzevoort, Wessel .
BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2024, 131 (08) :1042-1053