P10.29: Venous‐arterial pulsatility index in the prediction of fetal acidemia in pregnancies with placental insufficiency (original) (raw)
2005, Ultrasound in Obstetrics & Gynecology
Objectives: To evaluate the prediction of fetal acidemia using ductus venosus (DV) Dopplervelocimetry and to determine the best parameter and cutoff values for this prediction in pregnancies complicated with placental insufficiency. Patients and methods: This was a prospective cross-sectional study involving forty-seven patients with placental insufficiency managed in two Brazilian hospitals (Hospital São Paulo and Maternidade-Escola Assis Chateaubriand) who were submitted to DV Dopplervelocimetry in the last 24 hours before delivery. All pregnancies were singleton, over 26 weeks of age and without structural or chromosome anomalies. Metabolic or mixed acidemia at birth were considered pathological. A ROC curve was calculated for each DV parameter (independent variable) and acidemia (dependent variable). A cutoff value was established and sensibility, specificity, positive and negative predictive values and positive and negative likelihood ratios were calculated. The MacNemar test was used to compare the parameters. Results: The DV S, D and A peak velocities were not good predictors of acidemia at birth. Pulsatility Index for Veins (PIV) was a good predictor of acidemia (ROC curve area 0.79, p = 0.003), as well as the S/A and (S-A)/S ratios (ROC curve area 0.818, p = 0.001). The cut off values were PIV = 0.76, S/A = 2.67 and (S-A)/S = 0.63. Conclusions: In this high-risk population angle-independent DV Doppler indexes were good predictors of birth acidemia. PIV, S/A and (S-A)/S ratios were statistically equivalent in this prediction.
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