The significance of increasing umbilical artery systolic-diastolic ratios in third-trimester pregnancy.

摘要: Objective To evaluate the clinical significance of a marked increase in systolic-diastolic ratios (S/Ds) umbilical artery (UA) Doppler velocity waveforms third-trimester fetuses. Methods We evaluated 552 pregnancies at risk for placental insufficiency. Each patient had least five successive weekly UA velocimetry studies between 32-42 weeks and highest S/D within normal range gestational age. The was considered markedly increased if it 20% higher than mean four previous values. Clinical end points reviewed included mortality, fetal distress, 5-minute Apgar score below 7, metabolic acidosis, neonatal intensive care unit (NICU) admissions reasons other prematurity. Results S/Ds were 478 patients 74. two groups similar age testing delivery rates growth retardation low scores. group without birth weight lower incidences perinatal death, cesarean NICU admission. overall sensitivity (43%), specificity (90%), positive predictive value (27%), negative (95%) to our experience which we used criterion above 90th percentile. Conclusion Marked increases S/Ds, even an institutional "normal" range, may indicate fetus compromise.