Ductus venosus versus cerebral transverse sinus Doppler velocimetry for predicting acidemia at birth in pregnancies complicated by placental insufficiency

• Published in: Prenatal diagnosis 2013-12, Vol.33 (12), p.1146-1151
• Main Authors: Martins Neto, Manoel, Carvalho, Francisco Herlânio Costa, Barbosa, Maurício Mendes, Mota, Rosa Maria Salani, de Menezes, Denise Teixeira, Murta, Carlos Geraldo Viana, Santana, Renato Martins, Moron, Antonio Fernandes
• Format: Article
• Language: English
• Subjects: Acidosis - diagnosis; Acidosis - etiology; Cross-Sectional Studies; Female; Fetal Growth Retardation - etiology; Humans; Hydrogen-Ion Concentration; Laser-Doppler Flowmetry; Placental Insufficiency - diagnostic imaging; Pregnancy; Prenatal Diagnosis - methods; Prospective Studies; Pulsatile Flow; Sensitivity and Specificity; Ultrasonography, Prenatal; Umbilical Arteries; Veins - embryology
• ISSN: 0197-3851; 1097-0223
• DOI: 10.1002/pd.4208

ABSTRACT Objectives The objectives of this study is to compare ductus venosus (DV) and cerebral transverse sinus (CTS) Doppler velocimetry for predicting acidemia at birth in pregnancies complicated by placental insufficiency. Methods A prospective cross‐sectional study involving 69 cases. Doppler assessment of the DV and CTS was carried out in the last 24 hours prior to delivery. The sensitivity, specificity, positive and negative predictive values, and the accuracy and false‐positive and false‐negative rates were calculated for those parameters considered to be good predictors of acidemia. The McNemar test was used to compare the various parameters. Results The DV pulsatility index(PI), S/A, and (S − A)/S ratios as well as the CTS PI and the (S − A)/S ratio were good predictors of acidemia. The comparison between DV and CTS showed that for pulsatility index for veins, the sensitivity was 52.4% versus 66.7%, p = 0.508; the specificity was 81.2% versus 77.1%, p = 0.774; and the accuracy was 72.5% versus 73.9%, p = 1.00. For the (S − A)/S ratio the sensitivity was 52.4% versus 52.4%, p = 1.00; the specificity was 85.4% versus 79.2%, p = 0.508; and the accuracy was 75.4% versus 71%, p = 0.647. Conclusions In pregnancies with placental insufficiency, the PI and the (S − A)/S ratio of both DV and CTS were equally effective in predicting acidemia at birth. © 2013 John Wiley & Sons, Ltd. What's already known about this topic? Ductus venosus and cerebral transverse sinus Doppler velocimetry proved able to predict acidemia at birth. What does this study add? The Doppler cerebral transverse sinus showed the same ability to predict acidemia at birth as the ductus venosus Doppler in pregnancies with placental insufficiency