International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022
The pre-eclampsia, growth restriction, and ductus venosus doppler (GRADED) study: An observational study of early-onset fetal growth restriction and pre-eclampsia.
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Govender Vaeochan, Naidoo Thinagrin D, Foolchand Serantha
Аннотация
OBJECTIVE: To assess the feasibility of using ductus venosus Doppler (DVD) to time delivery in early-onset fetal growth restriction (FGR) and pre-eclampsia in a resource-constrained setting.
METHODS: This was a prospective, observational study of pregnancies affected by early-onset FGR and pre-eclampsia. Patient characteristics, risk factors, ultrasound findings, and pregnancy outcomes were entered into a data collection tool. The association of these variables with perinatal and maternal outcomes were determined using binary logistic regression analysis.
RESULTS: The study had 61 participants. Most patients were delivered at 29-31+6 weeks of pregnancy (67%). Neonates with an estimated fetal weight on ultrasound of less than 800 g had the highest incidence of perinatal mortality (63%). There was a near six-fold increase in risk of major neonatal morbidity in patients with abnormal DVD (odds ratio 5.9, 95% confidence interval [CI] 1.8-19.0). Absent flow in the DVD a-wave carried a higher risk of perinatal mortality (OR 23.8, 95% CI 1.7-334.8); 22% of patients with an abnormal DVD a-wave experienced placental abruption.
CONCLUSION: Having an abnormal DVD in the background of pre-eclampsia was related to increased perinatal morbidity and mortality, with increased risk of placental abruption.
METHODS: This was a prospective, observational study of pregnancies affected by early-onset FGR and pre-eclampsia. Patient characteristics, risk factors, ultrasound findings, and pregnancy outcomes were entered into a data collection tool. The association of these variables with perinatal and maternal outcomes were determined using binary logistic regression analysis.
RESULTS: The study had 61 participants. Most patients were delivered at 29-31+6 weeks of pregnancy (67%). Neonates with an estimated fetal weight on ultrasound of less than 800 g had the highest incidence of perinatal mortality (63%). There was a near six-fold increase in risk of major neonatal morbidity in patients with abnormal DVD (odds ratio 5.9, 95% confidence interval [CI] 1.8-19.0). Absent flow in the DVD a-wave carried a higher risk of perinatal mortality (OR 23.8, 95% CI 1.7-334.8); 22% of patients with an abnormal DVD a-wave experienced placental abruption.
CONCLUSION: Having an abnormal DVD in the background of pre-eclampsia was related to increased perinatal morbidity and mortality, with increased risk of placental abruption.