Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of intrauterine growth retardation: A prospective study

A prospective study was undertaken to examine whether Doppler velocimetry studies of the umbilical artery give a better or an earlier prediction of intrauterine growth retardation (IUGR) than do sonographic estimation of fetal weight. A total of 385 examinations were performed between 30 and 42 week...

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Veröffentlicht in:American journal of obstetrics and gynecology 1988-05, Vol.158 (5), p.1149-1153
Hauptverfasser: Berkowitz, Gertrud S., Chitkara, Usha, Rosenberg, Joanne, Cogswell, Carolyn, Walker, Barbara, Lahman, Elizabeth A., Mehalek, Karen E., Berkowitz, Richard L.
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container_end_page 1153
container_issue 5
container_start_page 1149
container_title American journal of obstetrics and gynecology
container_volume 158
creator Berkowitz, Gertrud S.
Chitkara, Usha
Rosenberg, Joanne
Cogswell, Carolyn
Walker, Barbara
Lahman, Elizabeth A.
Mehalek, Karen E.
Berkowitz, Richard L.
description A prospective study was undertaken to examine whether Doppler velocimetry studies of the umbilical artery give a better or an earlier prediction of intrauterine growth retardation (IUGR) than do sonographic estimation of fetal weight. A total of 385 examinations were performed between 30 and 42 weeks of gestation on 168 patients who were at risk for IUGR. Forty-two (25%) of the patients delivered an infant with a birth weight below the tenth percentile. Although sensitivity was lower for the systolic to diastolic ratio (55%) of the umbilical artery than for the sonographic estimation of fetal weight (76%), the umbilical artery studies had a higher specificity (92% versus 80%) and predictive value of a positive test (73% versus 58%) when the last study to delivery interval was within 2 weeks. Furthermore, among 21 IUGR pregnancies with serial studies, the umbilical systolic to diastolic ratio was abnormal at a significantly earlier gestational age than when the sonographic estimate of fetal weight identified growth retardation. These findings indicate that sonographic biometry is a more sensitive technique for identifying IUGR but that the umbilical artery waveforms are a valuable adjunct for improving the diagnostic accuracy for the prenatal detection of IUGR. These data also provide suggestive evidence that umbilical artery velocimetry may be predictive of IUGR at an earlier gestational age than sonographic estimation of fetal weight.
doi_str_mv 10.1016/0002-9378(88)90243-8
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A total of 385 examinations were performed between 30 and 42 weeks of gestation on 168 patients who were at risk for IUGR. Forty-two (25%) of the patients delivered an infant with a birth weight below the tenth percentile. Although sensitivity was lower for the systolic to diastolic ratio (55%) of the umbilical artery than for the sonographic estimation of fetal weight (76%), the umbilical artery studies had a higher specificity (92% versus 80%) and predictive value of a positive test (73% versus 58%) when the last study to delivery interval was within 2 weeks. Furthermore, among 21 IUGR pregnancies with serial studies, the umbilical systolic to diastolic ratio was abnormal at a significantly earlier gestational age than when the sonographic estimate of fetal weight identified growth retardation. These findings indicate that sonographic biometry is a more sensitive technique for identifying IUGR but that the umbilical artery waveforms are a valuable adjunct for improving the diagnostic accuracy for the prenatal detection of IUGR. 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These data also provide suggestive evidence that umbilical artery velocimetry may be predictive of IUGR at an earlier gestational age than sonographic estimation of fetal weight.</description><subject>Adult</subject><subject>Blood Flow Velocity</subject><subject>Body Weight</subject><subject>Doppler umbilical artery velocimetry</subject><subject>Female</subject><subject>Fetal Growth Retardation - diagnosis</subject><subject>Fetal Growth Retardation - physiopathology</subject><subject>fetal weight</subject><subject>Fetus - pathology</subject><subject>Gestational Age</subject><subject>growth retardation</subject><subject>Humans</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>Ultrasonography</subject><subject>ultrasound</subject><subject>Umbilical Arteries - physiopathology</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1988</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UUtvEzEQthCoDYV_QCWfUDks-JH4waFSVZ5SpR4KZ8uxZxNXu-vF9qbKD-J_4m3SHjl5rPkeM98g9I6Sj5RQ8YkQwhrNpbpQ6oMmbMkb9QItKNGyEUqol2jxDDlFr3O-n79MsxN0wplaCSUX6O9dHOIm2XEbHIZcQm9LiAOOLW6h2A4_QNhsC7aDx1_iOHaQam27fQ55Bk39OnTBVaBNBdIe76CLLvRQah0GXLaAxwQ-uCfZMJRkp4oNA-BNig9li1O1Sv7R-TO-qoSYR6iMHeBcJr9_g161tsvw9vieod_fvv66_tHc3H7_eX110zi-kqXRAFRxbqki0q-ooMR7udLgNaVMCirWRDvtiAbCWQutsl4Qz6QWS9CEK36G3h906wR_phqH6UN20HV2gDhlIxVjRHNegcsD0NVRc4LWjKlGl_aGEjNfx8xZmzl6o5R5vI6Z9c-P-tO6B_9MOp6j9i8PfahL7gIkk12AwdX8Us3D-Bj-b_APdraikQ</recordid><startdate>19880501</startdate><enddate>19880501</enddate><creator>Berkowitz, Gertrud S.</creator><creator>Chitkara, Usha</creator><creator>Rosenberg, Joanne</creator><creator>Cogswell, Carolyn</creator><creator>Walker, Barbara</creator><creator>Lahman, Elizabeth A.</creator><creator>Mehalek, Karen E.</creator><creator>Berkowitz, Richard L.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19880501</creationdate><title>Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of intrauterine growth retardation: A prospective study</title><author>Berkowitz, Gertrud S. ; 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A total of 385 examinations were performed between 30 and 42 weeks of gestation on 168 patients who were at risk for IUGR. Forty-two (25%) of the patients delivered an infant with a birth weight below the tenth percentile. Although sensitivity was lower for the systolic to diastolic ratio (55%) of the umbilical artery than for the sonographic estimation of fetal weight (76%), the umbilical artery studies had a higher specificity (92% versus 80%) and predictive value of a positive test (73% versus 58%) when the last study to delivery interval was within 2 weeks. Furthermore, among 21 IUGR pregnancies with serial studies, the umbilical systolic to diastolic ratio was abnormal at a significantly earlier gestational age than when the sonographic estimate of fetal weight identified growth retardation. 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subjects Adult
Blood Flow Velocity
Body Weight
Doppler umbilical artery velocimetry
Female
Fetal Growth Retardation - diagnosis
Fetal Growth Retardation - physiopathology
fetal weight
Fetus - pathology
Gestational Age
growth retardation
Humans
Pregnancy
Prospective Studies
Ultrasonography
ultrasound
Umbilical Arteries - physiopathology
title Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in the prediction of intrauterine growth retardation: A prospective study
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