کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6145405 | 1594912 | 2014 | 10 صفحه PDF | دانلود رایگان |
ObjectiveThe purpose of this study was to evaluate the surveillance characteristics that precede stillbirth in growth-restricted fetuses that receive integrated Doppler and biophysical profile scoring (BPS).Study DesignNine hundred eighty-seven singleton pregnancies that were complicated by fetal growth restriction had multivessel Doppler scans (umbilical and middle cerebral arteries [MCA], ductus venosus, and umbilical vein) and BPS. Surveillance findings were compared between live births and stillbirths.ResultsForty-seven stillbirths occurred in 2 clusters, 37 at <34 weeks of gestation and 10 thereafter. Before 34 weeks of gestation, stillbirths had parallel escalation of umbilical artery and ductus venosus Doppler findings followed by abnormal BPS. At â¥34 weeks of gestation, only a decline in MCA pulsatility index was observed, and 75% of stillbirths were unanticipated by the BPS.ConclusionBefore 34 weeks of gestation, multivessel Doppler abnormality anticipates an abnormal BPS and subsequent stillbirth. After 34 weeks of gestation, stillbirths occur after MCA brain-sparing in a shorter interval than predicted by a normal BPS. Recognition of these differences in clinical behavior requires consideration for the planning of monitoring intervals in preterm and term fetal growth restriction.
Journal: American Journal of Obstetrics and Gynecology - Volume 211, Issue 6, December 2014, Pages 669.e1-669.e10