Gestational age at delivery and Doppler waveforms in very preterm intrauterine growth-restricted fetuses as predictors of perinatal mortality

Giancarlo Mari, Farhan Hanif, Marjorie C. Treadwell, Michael Kruger

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36 Citations (Scopus)

Abstract

Objective. The aim of this study was to compare gestational age at delivery and the performance of middle cerebral artery (MCA), ductus venosus (DV), and umbilical artery Doppler parameters in the prediction of perinatal mortality and morbidity in intrauterine growth-restricted (IUGR) fetuses delivered at 32 weeks or earlier. Methods. The study population consisted of 41 patients with IUGR fetuses. Delivery occurred for maternal or fetal indications. Two-tailed χ2 and Fisher exact tests, an independent t test, and logistic regression were used for the analysis. P < .05 was considered statistically significant. Results. Gestational age at delivery ranged between 23.1 and 32 weeks (median, 27.6 weeks). There were 17 perinatal deaths. Ninety-four percent of the perinatal deaths occurred when the fetuses were delivered before 29 weeks. No fetus survived when delivered before 25 weeks. Two parameters predicted the perinatal mortality: gestational age at delivery (odds ratio, 0.52; 95% confidence interval, 0.31-0.88) and the combination of abnormal MCA peak systolic velocity + DV reversed flow (odds ratio, 10.2; 95% confidence interval, 1.8-57). For each week of pregnancy, there was a reduction in perinatal mortality of 48%. No Doppler parameters were significantly associated with perinatal morbidity. Conclusions. Gestational age at delivery and the combination of abnormal MCA peak systolic velocity + DV reversed flow in very preterm IUGR fetuses were the best parameters in predicting perinatal mortality. The decreased perinatal mortality that is found for each week IUGR fetuses remain in utero should be taken into account when a decision to deliver an IUGR fetus before 30 weeks is made.

Original languageEnglish (US)
Pages (from-to)555-559
Number of pages5
JournalJournal of Ultrasound in Medicine
Volume26
Issue number5
DOIs
StatePublished - Jan 1 2007

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Perinatal Mortality
Gestational Age
Fetus
Growth
Middle Cerebral Artery
Odds Ratio
Confidence Intervals
Morbidity
Umbilical Arteries
Logistic Models
Mothers
Pregnancy
Population

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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Gestational age at delivery and Doppler waveforms in very preterm intrauterine growth-restricted fetuses as predictors of perinatal mortality. / Mari, Giancarlo; Hanif, Farhan; Treadwell, Marjorie C.; Kruger, Michael.

In: Journal of Ultrasound in Medicine, Vol. 26, No. 5, 01.01.2007, p. 555-559.

Research output: Contribution to journalArticle

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