Venous-Arterial Doppler Ratios in the Prediction of Acidemia at Birth in Pregnancies with Placental Insufficiency

• Published in: Fetal diagnosis and therapy Vol. 21; no. 5; pp. 418 - 423
• Main Authors: Carvalho, F.H.C., Moron, A.F., Mattar, R., Murta, C.G.V., Santana, R.M., Barbosa, M.M., Torloni, M.R., Vasques, F.A.P.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2006; S. Karger AG
• Subjects: Acidosis - blood; Acidosis - diagnosis; Acidosis - etiology; Adolescent; Adult; Arteries; Biological and medical sciences; Cross-Sectional Studies; Diseases of mother, fetus and pregnancy; False Positive Reactions; Female; Gynecology. Andrology. Obstetrics; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Management. Prenatal diagnosis; Medical sciences; Middle Cerebral Artery; Placental Insufficiency - diagnostic imaging; Pregnancy; Pregnancy. Fetus. Placenta; Prospective Studies; Pulsatile Flow; ROC Curve; Sensitivity and Specificity; Ultrasonography, Doppler, Pulsed; Umbilical Arteries; Veins - embryology; Fetal acidemia; Doppler velocimetry; Ductus venosus; Venous-arterial ratio; Sonography; Doppler ultrasound study; Pregnancy disorders; Arantius canal; Prenatal Diagnosis; Placental insufficiency; Birth; Placenta diseases; Artery; Acidemia; Blood vessel; Female; Fetus; Ratio; Circulatory system; Predictive factor; Vein
• ISSN: 1015-3837; 1421-9964
• DOI: 10.1159/000093883

Objectives: Investigate the prediction of birth acidemia in pregnancies with placental insufficiency using two newly created venous-arterial Doppler ratios: pulsatility index (PI) of the ductus venosus (DV) over PI of the middle cerebral artery (MCA) and PI of the DV over PI of the umbilical artery and establish cut-off values for this prediction. Methods: This was a prospective cross-sectional study involving 47 patients with placental insufficiency managed in two Brazilian hospitals. All pregnancies were singleton, over 26 weeks of age and without structural or chromosome anomalies. A ROC curve was calculated for the venous-arterial ratios (independent variable) and acidemia (dependent variable). Results: The DV/AU PI ratio was not a good predictor of acidemia at birth. The DV/MCA PI ratio was related to fetal acidemia (area under the ROC curve 0.785, p = 0.004). The cut-off value was 0.582, sensibility 66.7%, specificity 77.1% and accuracy 74.5%. Conclusions: The DV/MCA PI ratio is adequate for the diagnosis of acidemia at birth in pregnancies with placental insufficiency. The cut-off value was 0.582.