The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction
Yıl: 2023 Cilt: 20 Sayı: 2 Sayfa Aralığı: 86 - 96 Metin Dili: İngilizce DOI: 10.4274/tjod.galenos.2023.87143 İndeks Tarihi: 07-06-2023
The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction
Öz: Objective: The aim of this study is to clarify the role of different Doppler parameters such as umbilicocerebral ratio (UCR), cerebroplacentouterine ratio (CPUR), aortic isthmus, renal artery, and umbilical vein flow Doppler in predicting adverse neonatal outcomes in fetuses with late -onset fetal growth restriction. Materials and Methods: The study included all patients diagnosed with fetal growth restriction at 32-39 weeks’ gestation between 01/02/2020 and 01/02/2022 and treated at the Department of Obstetrics and Gynecology, Inonu University School of Medicine. Results: Patients included in the study had a median gestational week at delivery of 37 (minimum 33+0-maximum 39+0), median CPR of 1.42 (minimummaximum 0.43-3.57), and median UCR of 0.7 (minimum-maximum 0.28-2.3). Receiver operating characteristic analysis was performed to determine the performance of the measured obstetric Doppler parameters in predicting the development of adverse neonatal outcomes. Umbilical venous blood flow showed the best performance in predicting adverse neonatal outcomes [area under the curve 0.952, 95% confidence interval (CI) 0.902-0.981, p<0.001]. Multivariate logistic regression analysis showed that fetuses with abnormal CPUR had a 4.5-fold (95% CI 0.084-0.583, p=0.02) increased risk of adverse neonatal outcome, whereas fetuses with abnormal umbilical venous flow had a 1.07-fold (95% CI 0.903-0.968, p<0.001) increased risk of adverse neonatal outcome. Conclusion: The results of this study demonstrate that the use of UCR, CPUR, umbilical venous flow, and aortic isthmus PI Doppler parameters along with umbilical artery PI and CPR are effective in predicting adverse neonatal outcomes in fetuses with late -onset fetal growth restriction.
Anahtar Kelime: Geç başlangıçlı intrauterin büyüme kısıtlılığı saptanan fetuslarda farklı Doppler parametrelerinin olumsuz neonatal sonuçları öngörmedeki rolü
Öz: Amaç: Bu çalışmanın amacı geç başlangıçlı fetal büyüme kısıtlılığı saptanan fetuslarda rutin obstetrik Doppler parametrelerine ek olarak umbilikoserebral oran (UCR), serebroplasentouterin oran, (CPUR), aortik istmus, renal arter Doppler ve umblikal ven kan akımı gibi farklı Doppler parametrelerinin fetustaki olumsuz neonatal sonuçları öngörmedeki rolünü açıklamaktır. Gereç ve Yöntemler: İnönü Üniversitesi Tıp Fakültesi Hastanesi, Kadın Hastalıkları ve Doğum Kliniği’ne 01.02.2020-01.02.2022 tarihleri arasında başvuran, gebeliğin 32-39. haftasında fetal büyüme kısıtlılığı saptanan, çalışma kriterlerine uygun tüm hastalar çalışmaya dahil edildi. Bulgular: Çalışmaya dahil edilen hastaların doğumda median gestasyonel haftası 37 olup (en küçük 33+0-en büyük 39+0), median serebroplasental oran (CPR) 1,42 (minimum-maksimum 0,43-3,57) ve median UCR 0,7 (minimum-maksimum 0,28-2,3) saptandı. Ölçülen obstetrik Doppler parametrelerinin olumsuz neonatal sonuçların gelişimini öngörmesi açısından performansının saptanması için Receiver Operating Characteristic analizi yapıldı. Umblikal ven kan akımı olumsuz neonatal sonuçları predikte etmede en iyi performansı gösterdi [Area under curve 0,952, %95 güven aralığı (GA) 0,902-0,981, p<0,001]. Çok değişkenli lojistik regresyon analizi, anormal CPUR’ye sahip fetusların 4,5 kat (%95 GA 0,084-0,583, p=0,02) olumsuz neonatal sonuç riskine sahip olduğunu, anormal umbilikal ven kan akımı olan fetuslarda ise 1,07 (%95 GA 0,903-0,968, p<0,001) kat daha fazla olumsuz neonatal sonuç riski olduğunu gösterdi. Sonuç: Bu çalışmanın sonuçları geç başlangıçlı fetal büyüme kısıtlılığı saptanan fetuslarda umblikal arter PI ve CPR ile birlikte UCR, CPUR, umblikal ven kan akımı ve aortik istmus PI Doppler parametrelerinin kullanımının neonatal olumsuz sonuçları predikte etmede etkin olduğunu göstermiştir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Yilmaz C, MELEKOGLU R, Özdemir H, YAŞAR Ş (2023). The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. , 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| Chicago | Yilmaz Cahit,MELEKOGLU RAUF,Özdemir Halis,YAŞAR Şeyma The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. (2023): 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| MLA | Yilmaz Cahit,MELEKOGLU RAUF,Özdemir Halis,YAŞAR Şeyma The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. , 2023, ss.86 - 96. 10.4274/tjod.galenos.2023.87143 |
| AMA | Yilmaz C,MELEKOGLU R,Özdemir H,YAŞAR Ş The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. . 2023; 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| Vancouver | Yilmaz C,MELEKOGLU R,Özdemir H,YAŞAR Ş The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. . 2023; 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| IEEE | Yilmaz C,MELEKOGLU R,Özdemir H,YAŞAR Ş "The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction." , ss.86 - 96, 2023. 10.4274/tjod.galenos.2023.87143 |
| ISNAD | Yilmaz, Cahit vd. "The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction". (2023), 86-96. https://doi.org/10.4274/tjod.galenos.2023.87143 |
| APA | Yilmaz C, MELEKOGLU R, Özdemir H, YAŞAR Ş (2023). The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. Turkish Journal of Obstetrics and Gynecology, 20(2), 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| Chicago | Yilmaz Cahit,MELEKOGLU RAUF,Özdemir Halis,YAŞAR Şeyma The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. Turkish Journal of Obstetrics and Gynecology 20, no.2 (2023): 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| MLA | Yilmaz Cahit,MELEKOGLU RAUF,Özdemir Halis,YAŞAR Şeyma The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. Turkish Journal of Obstetrics and Gynecology, vol.20, no.2, 2023, ss.86 - 96. 10.4274/tjod.galenos.2023.87143 |
| AMA | Yilmaz C,MELEKOGLU R,Özdemir H,YAŞAR Ş The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. Turkish Journal of Obstetrics and Gynecology. 2023; 20(2): 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| Vancouver | Yilmaz C,MELEKOGLU R,Özdemir H,YAŞAR Ş The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction. Turkish Journal of Obstetrics and Gynecology. 2023; 20(2): 86 - 96. 10.4274/tjod.galenos.2023.87143 |
| IEEE | Yilmaz C,MELEKOGLU R,Özdemir H,YAŞAR Ş "The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction." Turkish Journal of Obstetrics and Gynecology, 20, ss.86 - 96, 2023. 10.4274/tjod.galenos.2023.87143 |
| ISNAD | Yilmaz, Cahit vd. "The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction". Turkish Journal of Obstetrics and Gynecology 20/2 (2023), 86-96. https://doi.org/10.4274/tjod.galenos.2023.87143 |
