Clinical impact of Doppler reference charts on management of small-for-gestational-age fetuses: need for standardization.


Journal

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology
ISSN: 1469-0705
Titre abrégé: Ultrasound Obstet Gynecol
Pays: England
ID NLM: 9108340

Informations de publication

Date de publication:
08 2020
Historique:
received: 08 03 2019
revised: 09 06 2019
accepted: 17 06 2019
pubmed: 27 6 2019
medline: 15 12 2021
entrez: 26 6 2019
Statut: ppublish

Résumé

To assess clinical variability in the management of small-for-gestational-age (SGA) fetuses according to different published Doppler reference charts for umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler indices and cerebroplacental ratio (CPR). We performed a systematic search of MEDLINE, EMBASE, CINAHL and the Web of Science databases from 1954 to 2018 for studies with the sole aim of creating fetal Doppler reference values for UA, MCA and CPR. The top cited articles for each Doppler parameter were included. Variability in Doppler values at the following clinically relevant cut-offs was assessed: UA-pulsatility index (PI) > 95 From a total of 40 studies that met the inclusion criteria, 19 were analyzed (13 for UA-PI, 10 for MCA-PI and five for CPR). Wide discrepancies in reported Doppler reference values at clinically relevant cut-offs were found. MCA-PI showed the greatest variability, with differences of up to 51% in the 5 The choice of Doppler reference chart can result in significant variation in the clinical management of SGA fetuses, which may lead to suboptimal outcomes and inaccurate research conclusions. Therefore, an attempt to standardize fetal Doppler reference ranges is needed. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

Identifiants

pubmed: 31237023
doi: 10.1002/uog.20380
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

166-172

Informations de copyright

Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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Auteurs

S Ruiz-Martinez (S)

Aragon Institute of Health Research (IIS Aragón), Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.

A T Papageorghiou (AT)

Nuffield Department of Obstetrics and Gynaecology, Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.

E Staines-Urias (E)

Nuffield Department of Obstetrics and Gynaecology, Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.

J Villar (J)

Nuffield Department of Obstetrics and Gynaecology, Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.

R Gonzalez De Agüero (R)

Aragon Institute of Health Research (IIS Aragón), Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS, Instituto de Salud Carlos III (ISCIII), Subdirección General de Evaluación y Fomento de la Investigación y Fondo Europeo de Desarrollo Regional (FEDER), Spain.

D Oros (D)

Aragon Institute of Health Research (IIS Aragón), Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain.
Nuffield Department of Obstetrics and Gynaecology, Maternal and Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.
Red de Salud Materno Infantil y del Desarrollo (SAMID), RETICS, Instituto de Salud Carlos III (ISCIII), Subdirección General de Evaluación y Fomento de la Investigación y Fondo Europeo de Desarrollo Regional (FEDER), Spain.

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