PLACENTAL PULSATILITY INDEX AS A PREDICTOR OF CRITICAL PERINATAL OUTCOMES IN GROWTH RESTRICTED FETUSES
Main Article Content
Keywords
Fetal growth restriction (FGR), Placental pulsatility index (PPI), Uterine artery (Ut A), Umbilical artery (UA).
Abstract
Background and aim: In Obstetric Doppler, the pulsatility indices (PI) of the umbilical and uterine arteries are commonly used measures of utero-placental perfusion, when the PI of the two are combined, it reflects the total placental vascular impedance in terms of placental pulsatility index (PPI), the objective of this study was to use PPI in pregnancies suspected of fetal growth restriction to identify those that need more frequent and intense surveillance and also predict the critical perinatal outcomes. Methods: Umbilical and uterine artery indices were calculated using pulsed-wave Doppler in a study of 90 pregnancies (irrespective of maternal health status, with a minimum of 2 observations per patient) during 26–40 weeks of gestation. Placental pulsatility index was calculated as: (umbilical artery pulsatility index + mean of the left and right uterine artery pulsatility indices)/2, and mean +2 SD defined as abnormal and its ability was tested to predict adverse pregnancy outcomes in suspected pregnancies with fetal growth restriction. Results:The sensitivity and specificity of Placental pulsatility index as higher in predicting critical perinatal outcomes in pregnancies suspected of fetal growth restriction when compared with conventional umbilical and uterine artery pulsatility indices alone. Conclusions: The placental pulsatility index a reflector of utero placental perfusion, improves prediction of critical perinatal outcome in pregnancies suspected of fetal growth restriction.
Downloads
References
1) Bhide A, Acharya G, Baschat A, Bilardo CM, Brezinka C, Cafici D, Ebbing C, Hernandez- Andrade E, Kalache K, Kingdom J, Kiserud T. ISUOG Practice Guidelines (updated): use of Doppler velocimetry in obstetrics. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2021 Aug;58(2):331-9. 2) Norton ME. Callen's Ultrasonography in Obstetrics and Gynecology E-Book. Elsevier Health Sciences; 2016 Jul 2. 3) Bhide A, Acharya G, Baschat A, Bilardo CM, Brezinka C, Cafici D, Ebbing C, Hernandez- Andrade E, Kalache K, Kingdom J, Kiserud T. ISUOG Practice Guidelines (updated): use of Doppler velocimetry in obstetrics. Ultrasound in obstetrics & gynecology: the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2021 Aug;58(2):331-9. 4) An S, Li S. Doppler assessment of the fetus with intrauterine growth restriction: Society for Maternal-Fetal Medicine Clinical Guideline. Chinese Journal of Medical Ultrasound (Electronic Edition). 2017 May 1;14(05):394. 5) Gudmundsson S, Flo K, Ghosh G, Wilsgaard T, Acharya G. Placental pulsatility index: a new, more sensitive parameter for predicting adverse outcome in pregnancies suspected of fetal growth restriction. Acta Obstetricia et Gynecologica Scandinavica. 2017 Feb;96(2):216-22. 6) Resnik R. Intrauterine growth restriction. Obstet Gynecol 2002;99(3):490–496. 7) Committee on Practice Bulletins–Obstetrics and the American Institute of Ultrasound in Medicine. Practice bulletin no. 175: ultrasound in pregnancy. Obstet Gynecol 2016;128(6):e241–e256 8) Lees CC, Stampalija T, Baschat AA, da Silva Costa F, Ferrazzi E, Figueras F, Hecher K, Poon LC, Salomon LJ, Unterscheider J. ISUOG Practice Guidelines: diagnosis and management of small-for-gestational-age fetus and fetal growth restriction. Ultrasound in Obstetrics & Gynecology. 2020;56(2):298-312. 9) Spinillo A, Montanari L, Bergante C, Gaia G, Chiara A, Fazzi E. Prognostic value of umbilical artery Doppler studies in unselected preterm deliveries. Obstet Gynecol. 2005;105:613–620. 10) Barbieri C. Doppler ultrasound in high risk pregnancies. Department of Obstet Gynecol of the Center for Integral Attention to Women's Health. [Last accessed on 2010 Oct 6]. 11) Hernandez‐Andrade E, Brodszki J, Lingman G, Gudmundsson S, Molin J, Maršál K. Uterine artery score and perinatal outcome. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2002 May 1;19(5):438-42.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.