The predictors of poor outcome in early onset fetal growth restriction (original) (raw)
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Predictors of outcome at 2 years of age after early intrauterine growth restriction
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2010
To examine the relative importance of antenatal and perinatal variables on short- and long-term outcome of preterm growth restricted fetuses with umbilical artery (UA) Doppler abnormalities. This was a cohort study of 180 neonates with birth weight < 10(th) percentile, gestational age at delivery < 34 weeks and abnormal Doppler ultrasound examination of the UA. Various antenatal and perinatal variables were studied in relation to short- and long-term outcome. Neonatal and overall mortality (up to 2 years of age) were predicted by low gestational age at delivery. Neonatal mortality was additionally predicted by absent or reversed UA end-diastolic flow, while the presence of severe neonatal complications and placental villitis were additional predictors of both infant (between 28 days and 1 year of postnatal life) and overall mortality. Placental villitis was found to be the only predictor of necrotizing enterocolitis. Low gestational age at delivery, male sex, abnormal cardioto...
Second trimester prediction of small for gestational age and intrauterine growth restriction
Clinical and Experimental Obstetrics & Gynecology, 2020
Aim: To analyze second trimester risk factors to predict small for gestational age and intrauterine growth restriction (IUGR) fetuses. Materials and Methods: The authors retrospectively analyzed clinical files of 5,390 women, who delivered between 2007 and 2009, 4,071 of which were included in the study. Adequate for gestational age (AGA), small for gestational age (SGA), and IUGR fetuses were included. Results: The authors found IUGR to be delivered significantly earlier than SGA and AGA. Moreover, they found a higher prevalence of nulliparity in SGA and IUGR fetuses than in AGA, and a significant higher prevalence of bilateral notch in SGA than AGA. SGA fetuses at 20 gestational weeks present a significantly higher value of umbilical artery pulsatility index (PI) and mean uterine arteries resistance index (RI) than AGA. In multivariate logistic regression analysis, the second trimester factors to predict SGA at delivery were: mother age, nulliparity, academic title, umbilical artery PI at 20 gestational weeks, mean RI of uterine arteries, and bilateral notch. In case of IUGR the most predictive factors were: mother age, nulliparity, and bilateral notch at 20 gestational weeks. Conclusions: Clinical interview and sonographic examination at 20 gestational weeks were capable to predict fetal growth potential.
The Egyptian Journal of Hospital Medicine, 2021
Background: Intrauterine growth restriction is one of the most common causes of perinatal morbidity and mortality worldwide. Strong evidence about the optimum method of surveillance is needed. Objective: to determine the relationship between biophysical fetal parameters and arterial and venous Doppler parameters in fetuses with severe intrauterine growth restriction (IUGR). Patients and Methods: This is a Prospective cohort study was conducted at Menoufia University Hospital during the period from March 2019 to September 2020. Fourty two IUGR fetuses with elevated Umbilical Artery (UA) Doppler had follow up with Doppler (UA, middle cerebral artery and ductus venosus) and Biophysical profile (BPP). Patients were stratified into three groups: G1: abnormal UA alone. G2: brain sparing effect. G3: abnormal DV Doppler. Our main primary outcome was neonatal intensive care unit (NICU) admission while secondary outcomes were APGAR score, Birth weight, EFW and stillbirth rate. Results UAEDV w...
BMC Pregnancy and Childbirth, 2014
Background: Intrauterine growth restriction (IUGR) is the single largest contributing factor to perinatal mortality in non-anomalous fetuses. Advances in antenatal and neonatal critical care have resulted in a reduction in neonatal deaths over the past decades, while stillbirth rates have remained unchanged. Antenatal detection rates of fetal growth failure are low, and these pregnancies carry a high risk of perinatal death.
Prenatal Diagnosis, 2020
The use of fetal arterial and venous Doppler studies is well acknowledged in the context of fetal growth restriction, with ductus venosus evaluation as the most correlated with fetal acidosis and impending risk of death. What does this study add? In a subpopulation of severely growth restricted fetuses, the use of z-score instead of gestational age or fetal weight alone may perform better in a prediction model including biometric and Doppler variables.
Taiwanese Journal of Obstetrics and Gynecology, 2015
Objective: To determine the factors which affect the perinatal deaths in early and late fetal growth restriction (FGR) fetuses using threshold of estimated fetal weight (EFW) < 5 th percentile. Materials and Methods: This retrospective study included singleton 271 FGR fetuses, defined as an EFW < 5 th percentile. All fetuses considered as growth restrictions were confirmed by birth weight. Fetuses with multiple pregnancy, congenital malformation, chromosomal abnormality, and premature rupture of membrane were excluded. Samples were grouped in early and late FGR. Early FGR fetuses was classified as gestational age at birth 34 weeks and late FGR was classified as gestational age at birth > 34 weeks. Factors which affect the perinatal deaths were analyzed descriptively in early and late FGR. The perinatal mortality was calculated by adding the number of stillbirths and neonatal deaths. Results: The study included 86 early and 185 late FGR fetuses, 31 resulted in perinatal deaths, 28 perinatal deaths were in early FGR, and three perinatal deaths were in late FGR. Perinatal deaths occurred more commonly in early FGR fetuses with an EFW < 3 rd percentile. Prior stillbirth, preeclampsia, the degree of increasing vascular impedance of umbilical artery(UA) and uterine artery (UtA) showed significant correlation with perinatal death in early FGR. All three perinatal deaths in late FGR occurred in fetuses with EFW < 3 rd percentile and severe oligohydramnios. Also, placental abruption and perinatal death was found significantly higher in increased vascular impedance of UtAs whatever the umbilical artery Doppler. Conclusion: Only EFW < 3 rd percentile and severe olgohydramnios seem to be contributing factors affecting perinatal death in late FGR in comparison with early FGR.
American Journal of Perinatology Reports, 2015
Small for gestational age (SGA), defined as actual birth weight below 10% for gestational age (GA), is linked with intraventricular hemorrhage, neonatal seizures, sepsis, necrotizing enterocolitis, prolonged hospitalization, and increased hospital charges. SGA, compared with appropriate for gestational age (AGA; birth weight between 10 and 90% for GA), is at increased risk of stillbirths and neonatal and infant mortality. 1-8 According to six national guidelines, the mortality with SGA is reduced if fetal growth restriction (FGR)-sonographically estimated fetal weight (SEFW) < 10% for GA-is diagnosed, antenatal surveillance initiated, and delivery managed according to guidelines. 1,9-13 American College of Obstetricians and Gynecologist (ACOG) currently recommends that screening for suboptimal growth involves assessing risk factors for SGA and,