International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
Assessing fetal circulatory alterations in preeclampsia: The role of caval aortic index and left brachiocephalic vein diameter.
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Okutucu Gulcan, Tanacan Atakan, Ozden Tokalioglu Eda, Uzuner Petek Feriha, Kayaalp Huseyin, Agaoglu Zahid, Kara Ozgur, Sahin Dilek
Аннотация
OBJECTIVE: The primary objective of this study is to compare the fetal caval aortic (IVC/Ao) index and left brachiocephalic vein (LBCV) diameter between pregnancies with preeclampsia (PE) and healthy controls. The study also assesses their association with disease severity and perinatal outcomes.
METHODS: In this prospective case-control study, 60 pregnancies complicated by PE were compared with 60 gestational age-matched healthy controls. The fetal IVC/Ao index, LBCV diameter, Doppler parameters, and perinatal outcomes were assessed. Subgroup analyses in the PE group considered admission blood pressure, symptoms, proteinuria, and neonatal outcomes.
RESULTS: The PE group had a lower IVC/Ao index and larger LBCV diameter (P = 0.043 and P = 0.025, respectively). The umbilical artery pulsatility index was higher (P = 0.008), and the cerebroplacental ratio was lower (P = 0.005) in PE. Smaller ascending aorta diameter was noted in severe hypertension (P = 0.042), and the LBCV diameter was greater in symptomatic cases (P = 0.007). Proteinuria ≥+2 was associated with earlier delivery (P = 0.014) and lower birth weight (P < 0.001). Neonates admitted to the neonatal intensive care (NICU) had lower fetal inferior vena cava (IVC) diameters and lower IVC/Ao indices. An IVC/Ao index cutoff of 0.79 was associated with NICU admission, demonstrating moderate discriminatory performance (sensitivity 72.2%, specificity 73.8%, area under the curve = 0.762; 95% confidence interval 0.61-0.90; P = 0.001).
CONCLUSION: Fetuses of PE pregnancies had decreased IVC/Ao index and enlarged LBCV diameter, potentially linked to impaired fetal hemodynamics. The IVC/Ao index might help identify pregnancies complicated by PE that are at increased risk of NICU admission.
METHODS: In this prospective case-control study, 60 pregnancies complicated by PE were compared with 60 gestational age-matched healthy controls. The fetal IVC/Ao index, LBCV diameter, Doppler parameters, and perinatal outcomes were assessed. Subgroup analyses in the PE group considered admission blood pressure, symptoms, proteinuria, and neonatal outcomes.
RESULTS: The PE group had a lower IVC/Ao index and larger LBCV diameter (P = 0.043 and P = 0.025, respectively). The umbilical artery pulsatility index was higher (P = 0.008), and the cerebroplacental ratio was lower (P = 0.005) in PE. Smaller ascending aorta diameter was noted in severe hypertension (P = 0.042), and the LBCV diameter was greater in symptomatic cases (P = 0.007). Proteinuria ≥+2 was associated with earlier delivery (P = 0.014) and lower birth weight (P < 0.001). Neonates admitted to the neonatal intensive care (NICU) had lower fetal inferior vena cava (IVC) diameters and lower IVC/Ao indices. An IVC/Ao index cutoff of 0.79 was associated with NICU admission, demonstrating moderate discriminatory performance (sensitivity 72.2%, specificity 73.8%, area under the curve = 0.762; 95% confidence interval 0.61-0.90; P = 0.001).
CONCLUSION: Fetuses of PE pregnancies had decreased IVC/Ao index and enlarged LBCV diameter, potentially linked to impaired fetal hemodynamics. The IVC/Ao index might help identify pregnancies complicated by PE that are at increased risk of NICU admission.