Ductus venosus S-wave/isovolumetric A-wave (SIA) index and A-wave reversed flow in severely premature growth-restricted fetuses

Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
Jason L PicconiG Mari

Abstract

Ductus venosus (DV) Doppler waveforms show 2 periods of decreased velocity during iso-volumetric relaxation (isovolumetric relaxation velocity [IRV]) and atrial contraction (A wave or end-diastolic velocity [EDV]). In intrauterine growth-restricted (IUGR) fetuses, both may become abnormal. The hypothesis for this study was that in severely premature IUGR fetuses, Doppler assessment of both the IRV and EDV allows a more accurate prediction of fetal outcome than absent/reversed end-diastolic flow (A/REDF) alone. Ductus venosus Doppler waveforms were serially studied in 49 severely premature IUGR fetuses from diagnosis until death or delivery. The DV waveforms were assessed for peak systolic velocity (PSV), IRV, and EDV and qualitatively for forward end-diastolic flow or A/REDF. The S-wave/isovolumetric A-wave (SIA) index [PSV/(IRV + EDV)] for each fetus was compared to fetal/neonatal outcomes. There were 8 cases of fetal death (FD), 9 cases of neonatal death (ND), and 32 cases of neonatal survival (NS). A receiver operating characteristic (ROC) curve for the SIA index in all cases showed that values less than -1.25 correlated with FD and those greater than -1.25 correlated with live birth, with 100% sensitivity and 100% specifici...Continue Reading

References

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Citations

Nov 5, 2013·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·L SanapoA A Baschat
Dec 1, 2019·Acta Obstetricia Et Gynecologica Scandinavica·Nicola FratelliBasky Thilaganathan
Sep 10, 2013·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·O M TuranA A Baschat
May 21, 2016·Journal of Neonatal-perinatal Medicine·I AdityaT Mondal

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