Normative references and clinical correlates of fetal umbilical artery Doppler indices in southwestern Nigeria.
Fetal growth restriction
Fetal umbilical artery Doppler
Nigeria
Pulsatility index
Reference ranges
Resistance index
Stillbirth
Systolic/diastolic ratio
Journal
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
ISSN: 1879-3479
Titre abrégé: Int J Gynaecol Obstet
Pays: United States
ID NLM: 0210174
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
13
10
2019
revised:
01
04
2020
accepted:
29
06
2020
pubmed:
4
7
2020
medline:
2
4
2021
entrez:
4
7
2020
Statut:
ppublish
Résumé
To derive normative references for umbilical artery (UA) Doppler indices, including pulsatility index (PI), resistance index (RI), and systolic/diastolic (SD) ratio, for singleton pregnancies in Ile-Ife, Nigeria, and compare them with reference values from other populations. A longitudinal study involving 415 women with a singleton fetus at 26-40 gestational weeks attending Obafemi Awolowo University Hospital, Ile-Ife, between July 2015 and March 2019. Fetal UA PI, RI, and SD ratio were measured every 4 weeks until delivery. Reference values from the 2.5th to the 97.5th centiles were derived from 1375 measurements. Correlations between indices and bio-demographic characteristics were assessed; regression equations were generated. The RI, PI, and SD ratio decreased by 0.013, 0.027, and 0.71, respectively, for each additional week of pregnancy. There was a negative correlation between the three indices and birthweight (P<0.001), but not maternal parity, age, or fetal gender. Regression equations for RI, PI, and SD ratio were, respectively, 1.004 - 0.013x, 1.78 - 0.027x, and 4.77 - 0.71x, where x is gestational age (weeks). The derived normative references for fetal UA Doppler indices are recommended for monitoring high-risk pregnancies in Nigeria. The indices are comparable to those derived from Norwegian, Thai, and British cohorts.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
134-140Informations de copyright
© 2020 International Federation of Gynecology and Obstetrics.
Références
World Health Organization. Organization and Partnership for Maternal, Neonatal and Child Health. Stillbirths: The Invisible Public Health Problem. Geneva: WHO; 2012.
World Health Organization. Maternal, Newborn, Child and Adolescent Health: Stillbirth. Geneva: WHO; 2012.
Cousens S, Blencowe H, Stanton C et al National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: A systematic analysis. Lancet. 2011;377:1319-1330.
Haws RA, Yakoob MY, Soomro T, Menezes EV, Darmstadt GL, Bhutta ZA. Reducing stillbirths: Screening and monitoring during pregnancy and labour. BMC Pregnan Childbirth. 2009;9:1-48.
Fawole AO, Shah A, Tongo O et al Determinants of perinatal mortality in Nigeria. Int J Gynecol Obstet. 2011;114:37-42.
Kuti O, Awowole I, Okunola T. Audit of stillbirths in a Nigerian teaching hospital. Trop J Obstet Gynaecol. 2017;34:188-194.
Liston R, Sawchuck D, Young D. Fetal health surveillance: Antepartum and intrapartum consensus guideline. J Obstet Gynaecol Can. 2007;29(9 Suppl 4):S3-S56.
Gagnon R, Van den Hof M. Diagnostic Imaging Committee of the Society of Obstetricians and Gynaecologists of Canada Clinical Practice Guidelines: The use of Fetal Doppler in Obstetrics. J Obstet Gynaecol Can. 2003;25:601-607.
Alfirevic Z, Stampalija T, Gyte GM. Fetal and umbilical Doppler ultrasound in high-risk pregnancies. Cochrane Database Syst Rev. 2010;(1):CD007529.
Baschat AA. Venous Doppler evaluation of the growth-restricted fetus. Clin Perinatol. 2011;38:103-112.
Stampalija T, Alfirevic Z, Gyte G. Doppler in obstetrics: Evidence from randomized trials. Ultrasound Obstet Gynecol. 2010;36:779-780.
Baschat AA, Gembruch U, Reiss I, Gortner L, Weiner CP, Harman CR. Relationship between arterial and venous Doppler and perinatal outcome in fetal growth restriction. Ultrasound Obstet Gynecol. 2000;16:407-413.
Pourcelot L. Velocimetrie ultrasonore Doppler Seminaire. INSERM. 1974;2:213-240.
Gosling RG, King DH. Arterial assessment by Doppler-shift ultrasound. Proc R Soc Med. 1974;67:447-449.
Stuart B, Drumm J, FitzGerald DE, Duignan NM. Fetal blood velocity waveforms in normal pregnancy. BJOG. 1980;87:780-785.
Harrington K, Carpenter RG, Goldfrad C, Campbell S. Transvaginal Doppler ultrasound of the uteroplacental circulation in the early prediction of pre-eclampsia and intrauterine growth retardation. BJOG. 1997;104:674-681.
Baschat AA. Doppler application in the delivery timing of the preterm growth-restricted fetus: Another step in the right direction. Ultrasound Obstet Gynecol. 2004;23:111-118.
Yakasai IA, Tabari MA, Rabiu A, Ismail AM. Pattern of fetal arterial blood flow in selected vessels in patients with pregnancy induced hypertension in Aminu Kano Teaching Hospital Kano, Nigeria. West Afr J Radiol. 2013;20:9-13.
Ajayi GO. The effect of appropriate and small for gestational age pregnancies on somatomedin-C(SMC)/IGF-I), human placental lactogen and Doppler velocimetry in Nigerian Women. Afr J Endo Metabol. 2002;3:49-51.
Ciobanu A, Wright A, Syngelaki A, Wright D, Akolekar R, Nicolaides K. Fetal Medicine Foundation reference ranges for umbilical artery and middle cerebral artery pulsatility index and cerebroplacental ratio. Ultrasound Obstet Gynecol. 2019;53:465-472.
International Electrotechnical Commission. IEC 60601-2-37 Ed. 2.0. Medical electrical equipment - Part 2-37: Particular requirements for the basic safety and essential performance of ultrasonic medical diagnostic and monitoring equipment. Geneva: IEC; 2007.
Bhide A, Acharya G, Bilardo CM et al ISUOG practice guidelines: Use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol. 2013;41:233-239.
Baschat AA. Arterial and venous Doppler in the diagnosis and management of early onset fetal growth restriction. Early Hum Dev. 2005;81:877-887.
Acharya G, Wilsgaard T, Berntsen GK, Maltau JM, Kiserud T. Reference ranges for serial measurements of umbilical artery Doppler indices in the second half of pregnancy. Am J Obstet Gynecol. 2005;192:937-944.
Konje JC, Abrams KR, Taylor DJ. Normative values of Doppler velocimetry of five major fetal arteries as determined by color power angiography. Acta Obstetricia et Gynecologica Scandinavica. 2005;84:230-237.
Chanprapaph P, Wanapirak C, Tongsong T. Umbilical artery Doppler waveform indices in normal pregnancies. Thai J Obstet Gynaecol. 2000;12:103-107.
Acharya G, Wilsgaard T, Berntsen GK, Maltau JM, Kiserud T. Doppler-derived umbilical artery absolute velocities and their relationship to fetoplacental volume blood flow: A longitudinal study. Ultrasound Obstet Gynecol. 2005;25:444-453.
Acharya G, Wilsgaard T, Rosvold Berntsen GK et al Reference ranges for umbilical vein blood flow in the second half of pregnancy based on longitudinal data. Prenat Diagn. 2005;25:99-111.
Thompson RS, Trudinger BJ, Cook CM. Doppler ultrasound waveform indices: A/B ratio, pulsatility index and Pourcelot ratio. BJOG. 1988;95:581-588.
Acharya G, Erkinaro T, Makikallio K, Lappalainen T, Rasanen J. Relationships among Doppler-derived umbilical artery absolute velocities, cardiac function, and placental volume blood flow and resistance in fetal sheep. Am J Physiol Heart Circ Physiol. 2004;286:H1266-H1272.
Acharya G, Wilsgaard T, Berntsen GK, Maltau JM, Kiserud T. Reference ranges for serial measurements of blood velocity and pulsatility index at the intra-abdominal portion, and fetal and placental ends of the umbilical artery. Ultrasound Obstet Gynecol. 2005;26:162-169.
Ayoola OO, Bulus P, Loto OM, Idowu BM. Normogram of umbilical artery Doppler indices in singleton pregnancies in south-western Nigerian women. J Obstet Gynae Res. 2016;42:1694-1698.