Umbilical vein blood volume flow rate and umbilical artery pulsatility as 'venous-arterial index' in the prediction of neonatal compromise

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
M TchirikovH J Schröder

Abstract

To assess the diagnostic power of the umbilical venous-arterial index (VAI) for the prediction of poor fetal outcome. This was a retrospective, cross-sectional clinical study in which normalized umbilical vein blood volume flow rate (nUV) (mL/min/kg estimated body weight), umbilical artery pulsatility index (UAPI), the newly developed VAI (nUV/UAPI), and the uterine artery resistance index (UTRI) were determined in 85 fetuses once (17-41 gestational weeks) during pregnancy using standard ultrasound Doppler equipment. A risk score based on umbilical blood pH, 1-min Apgar score, birth weight, duration of gestation, type of respiratory support, and referral to the pediatric department was constructed, and fetuses were assigned to a control or a pathological group accordingly. Logistic regression and analysis of fitted receiver-operating characteristics curves were performed to evaluate the diagnostic power of nUV, UAPI, UTRI, and VAI. The incidence of compromised neonates was 17.6%. The area under the receiver-operating characteristics curve was larger for VAI than for UTRI or for UAPI (P < 0.002). At a cut-off value of 100 mL/min/kg, the sensitivity of VAI to predict poor neonatal outcome was 85% with a 15% false-positive rate. D...Continue Reading

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Citations

Nov 5, 2003·Clinical Obstetrics and Gynecology·Christopher R Harman, A A Baschat
Mar 20, 2010·Journal of Perinatal Medicine·Michael TchirikovAlexander Scholz
Jul 2, 2008·The International Journal of Neuroscience·Tiffany Field, Miguel Diego
May 18, 2010·Infant Behavior & Development·Tiffany FieldMaria Hernandez-Reif
Jan 13, 2009·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Michael TchirikovBernd Hüneke
Aug 30, 2008·Early Human Development·Miguel DiegoVictor Hugo Gonzalez-Quintero
Aug 24, 2005·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·M TchirikovH J Schröder
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Related Concepts

Blood Flow Velocity
Prevalence Studies
Embryopathies
Pulsatile Flow
Retrospective Studies
Umbilical Vein
Fetal Ultrasonography
Doppler Ultrasound Imaging

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