• Aortic isthmus dopplerindicesand their associations with intrauterine growth restriction and other perinatal outcomes

Aortic isthmus dopplerindicesand their associations with intrauterine growth restriction and other perinatal outcomes

PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.4(76):28-32; doi 10.15574/PP.2018.76.28

Rasoul-Zadeh Y. G., Klimashkin А. А., Kayumova R. R.
Tashkent Pediatric Medical Institute, Uzbekistan
Horev Medical Center, Tashkent, Uzbekistan

Intrauterine Growth Restriction (IUGR) is still considered as one of the most serious and poorly understood complication of pregnancy. None of the ultrasound parameters traditionally used for this condition screening is still generally accepted. This stimulates further search for IUGR markers of screening and early diagnosis.

Purpose — to study fetal aortic isthmus Doppler in dices and to reveal possible associations with perinatal outcomes.

Patients and methods. This prospective cohort study was performed at maternity house based on Tashkent City Hospital No. 4 named after I. Irgashev, Study involved 74 women with IUGR and other perinatal outcomes fetuses and 71 women with normal pregnancies.

Results. In IUGR group we found reduction of amniotic fluid volume and increased umbilical artery blood flow (P<0.001). Study of aortic isthmus (Ao I) blood flow indices shows increase of AoI PI and AoI RI (Р=0.0063 and 0.0016 respectively) as well as increase of EDV, TAMXV, IFI (Р=0.0004, 0.0249 and 0.0412 respectively). Area under curve (AUC) of AoI EDV for prediction of newborn intensive care unit transfer was 0,423 (Standard error = 0.046; 95% CI 0.195–0.499). AoI IFI and AoI RI had AUC for low 5 minute Apgar score prediction 0.875 (Standard error = 0.070; 95% CI 0.738–1.000) and 0.829 (Standard error = 0.072; 95% CI 0.687–0.971) respectively. Our results could not demonstrate that aortic isthmus dopplerometry could predict fetal demise. Binary regression model analysis shows that aortic isthmus diastolic blood flow was independently associated with IUGR, amniotic fluid volume, and umbilical artery SD ratio.

Conclusions. Aortic isthmus blood flow study is seems to be a very promising in identifying fetuses with a high risk of IUGR. However, to clarify clinical signif' icance of this parameter, more extensive research is needed in a format of randomized controlled trial.

Key words: intra uterine growth restriction, aortic isthmus, Doppler.

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Article received: Sep 09, 2018. Accepted for publication: Dec 08, 2018.