International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025
Factors affecting the umbilical artery Doppler reference values in the second and third trimesters.
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Rahimi Sophia, Kingdom John C, Vayenas Arietta, Stratulat Vasilica, Melamed Nir
Аннотация
OBJECTIVE: To explore the contribution of selected methodological factors to the heterogeneity in published umbilical artery pulsatility index (UA-PI) reference charts.
METHODS: Cross-sectional study of uncomplicated singleton pregnancies that underwent assessment of UA Doppler at a single center. We explored the effects of the cohort characteristics (parity and estimated fetal weight [EFW] centile cut-off) and the statistical modeling approach used to construct the UA-PI centile reference charts.
RESULTS: 25 069 UA-PI measurements from 12 394 patients were analyzed. UA-PI centile values decreased as the minimal EFW centile inclusion cut-off of the study cohort increased. Interpretation of UA-PI using charts constructed from fetuses with EFW > 25th or 50th centiles resulted in a higher proportion of examinations with UA-PI > 95th centile compared with the chart based on fetuses with EFW⟩10th centile (11.5% and 13.2% versus 10.6% of the subgroup of small-for-gestational-age fetuses, respectively, P < 0.001). In contrast, parity and the statistical method used to construct the chart had minimal impact on the UA-PI centile reference charts. Considerable heterogeneity was identified among published UA-PI reference charts.
CONCLUSION: Variation in the distribution of EFW centiles across the populations used to construct the UA-PI reference chart may contribute to the heterogeneity observed in published charts.
METHODS: Cross-sectional study of uncomplicated singleton pregnancies that underwent assessment of UA Doppler at a single center. We explored the effects of the cohort characteristics (parity and estimated fetal weight [EFW] centile cut-off) and the statistical modeling approach used to construct the UA-PI centile reference charts.
RESULTS: 25 069 UA-PI measurements from 12 394 patients were analyzed. UA-PI centile values decreased as the minimal EFW centile inclusion cut-off of the study cohort increased. Interpretation of UA-PI using charts constructed from fetuses with EFW > 25th or 50th centiles resulted in a higher proportion of examinations with UA-PI > 95th centile compared with the chart based on fetuses with EFW⟩10th centile (11.5% and 13.2% versus 10.6% of the subgroup of small-for-gestational-age fetuses, respectively, P < 0.001). In contrast, parity and the statistical method used to construct the chart had minimal impact on the UA-PI centile reference charts. Considerable heterogeneity was identified among published UA-PI reference charts.
CONCLUSION: Variation in the distribution of EFW centiles across the populations used to construct the UA-PI reference chart may contribute to the heterogeneity observed in published charts.