Umbilical artery Doppler and umbilical cord pH at birth in small-for-gestational-age fetuses: valid estimate of their relationship
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Francesc Figueras
Abstract
Objective: To evaluate the relationship between umbilical artery pulsatility index and the umbilical cord pH in small-for-gestational-age fetuses.
Methods: Data were collected from all pregnancies seen in our Fetal Surveillance Unit that underwent antenatal monitoring for being small-for-gestational-age beyond 24 weeks of pregnancy. A linear regression was used to analyse the effect of the umbilical artery pulsatility index (UAPI) and umbilical artery pH at birth, assessing interaction and controlling for clinically meaningful antenatal, Doppler, biophysical and perinatal variables.
Results: A total of 117 pregnancies were included. According to the estimated model (which included all clinically significant confounders and statistically significant interactions), in cases with reactive cardiotography (CTG) a 1-unit increase in the UAPI resulted in a mean decrease of 0.021 (95% 0.05 to −0.005) units of umbilical artery pH at delivery. In the non-reactive CTG group a 1-unit increase in the UAPI resulted in a mean decrease of 0.02 (95% CI 0.059 to −0.019) units of umbilical artery pH at delivery. Finally, in fetuses with a pathological CTG a 1-unit increase in the UAPI resulted in a mean decrease of 0.149 (95% CI 0.107 to 0.19) units of umbilical artery pH at delivery.
Conclusions: The crude effect between umbilical artery velocimetry on umbilical artery pH at birth has to be interpreted with caution, since an important part of this effect is related to other factors that confound and modify the relationship. After controlling for confounders, it was only in fetuses with pathological CTG that the effect remained statistically significant.
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Articles in the same Issue
- Pregnancy outcome of euploid fetuses with increased nuchal translucency: how bad is the news?
- Cerebral edema on MRI in severe preeclamptic women developing eclampsia
- Smoking during pregnancy and bulimia nervosa in offspring
- Stimulation of hCG protein and mRNA in first trimester villous cytotrophoblast cells in vitro by glycodelin A
- Umbilical artery Doppler and umbilical cord pH at birth in small-for-gestational-age fetuses: valid estimate of their relationship
- Hemodynamics of the renal artery and descending aorta in fetuses with renal disease using color Doppler ultrasound – longitudinal comparison to normal fetuses
- Echocardiographic measurements in infants of diabetic mothers and macrosomic infants of nondiabetic mothers
- Obstetric and neonatal outcomes in apparently isolated mild fetal ventriculomegaly
- Visual analysis of antepartum fetal heart rate tracings: inter- and intra-observer agreement and impact of knowledge of neonatal outcome
- Multiple positive results during a neonatal screening program: a retrospective analysis of incidence, clinical implications and outcomes
- Thrombocytopoiesis in healthy term newborns
- Infected neonatal cephalohematomas caused by anaerobic bacteria
- Endothelin-1 concentrations in cord blood of neonates with meconium-stained amniotic fluid
- Fetal alcohol syndrome and pyloric stenosis: alcohol induced or an association?
- Course of pregnancy and birth in a patient with Bernard-Soulier syndrome – a case report