Prediction of neonatal acidosis by ductus venosus Doppler pattern in high risk pregnancies

Abstract

Study objective: Evaluate whether ductus venosus (DV) Doppler velocimetry might be a good diagnostic tool of neonatal acidosis than umbilical artery (UA) and middle cerebral artery (MCA) blood velocities. Design: Prospective observational study. Setting: High risk pregnancy unit of Ain Shams University Maternity Hospital. Patients: Thirty high-risk pregnant patients in their third trimester. Method: Recording of DV, UA and MCA blood velocity in complicated pregnancies referred to umbilical artery (UA) velocimetry as one aspect of fetal surveillance. Measurements and main results: DV S/D ratio was not reliable to predict hypoxia (AUC 66%), PI was weak (73%), but RI was reliable to predict hypoxia (AUC 88%). On comparing the diagnostic ability of DV RI and MCA S/D, DV RI showed a diagnostic ability than MCA S/D, AUC 88% and 82% respectively. Conclusion: Abnormal DV blood velocity is more frequently recorded in high-risk pregnancies than UA, MCA blood velocities. Ductus venosus resistance index (DV RI) appears to be a better predictor of perinatal outcome than MCA S/D.

Keywords

• High risk pregnancy
• Ductus venosus
• Perinatal hypoxia
• Doppler ultrasound