Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2026
Extent of Absent End Diastolic Flow in Umbilical Artery Doppler and Its Prediction of Adverse Perinatal Outcome-A Prospective Observational Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Dayalan Vinitra, Singh Arati, Gowda Raksha, Divya P, Kolar Geeta
Аннотация
OBJECTIVES: The primary objective of this prospective study was to identify the predictive value of the extent of absent end diastolic flow (AEDF) (Ta/Ttotal ratio) for the adverse perinatal outcome (APO) in growth-restricted fetuses with AEDF.
METHODS: In this prospective study, a novel parameter Ta/Ttotal ratio, was measured in fetal growth-restricted (FGR) Fetuses with AEDF in the umbilical artery (UA) Doppler between 26 and 34 weeks. All pregnancies were monitored throughout gestation and continued to be followed up till neonatal period for any APO. Ta represents the duration of AEDF, and Ttot denotes the total duration of the cardiac cycle (Ttotal) in the UA Doppler, which was recorded at the last examination before delivery.
RESULTS: Seventy-eight FGR fetuses with AEDF were included in the study. Mean gestational age (GA) at delivery, Ta/Ttotal ratio, and mean birth weight were 30.40 ± 4.02 weeks, 0.30 ± 0.10, and 992.82 ± 373.82 grams, respectively. Stillbirths 19 (25%) and neonatal deaths 6 (8%) were reported. Ta/Ttotal ratio cut-off of 0.42 predicted APO with 96% specificity, 82% positive predictive value (PPV), and 76% negative predictive value (NPV), though sensitivity was 36% (area under ROC curve, 0.70 [0.57-0.82], p < .001).
CONCLUSIONS: In fetuses with AEDF with normal DV Doppler, the extent of absent flow for ≥42% of the total cardiac cycle length might predict the risk of APO with high specificity and PPV.
METHODS: In this prospective study, a novel parameter Ta/Ttotal ratio, was measured in fetal growth-restricted (FGR) Fetuses with AEDF in the umbilical artery (UA) Doppler between 26 and 34 weeks. All pregnancies were monitored throughout gestation and continued to be followed up till neonatal period for any APO. Ta represents the duration of AEDF, and Ttot denotes the total duration of the cardiac cycle (Ttotal) in the UA Doppler, which was recorded at the last examination before delivery.
RESULTS: Seventy-eight FGR fetuses with AEDF were included in the study. Mean gestational age (GA) at delivery, Ta/Ttotal ratio, and mean birth weight were 30.40 ± 4.02 weeks, 0.30 ± 0.10, and 992.82 ± 373.82 grams, respectively. Stillbirths 19 (25%) and neonatal deaths 6 (8%) were reported. Ta/Ttotal ratio cut-off of 0.42 predicted APO with 96% specificity, 82% positive predictive value (PPV), and 76% negative predictive value (NPV), though sensitivity was 36% (area under ROC curve, 0.70 [0.57-0.82], p < .001).
CONCLUSIONS: In fetuses with AEDF with normal DV Doppler, the extent of absent flow for ≥42% of the total cardiac cycle length might predict the risk of APO with high specificity and PPV.