Doppler and biophysical assessment in growth restricted fetuses: Distribution of test results

Ahmet Baschat, H. L. Galan, A. Bhide, C. Berg, M. L. Kush, D. Oepkes, B. Thilaganathan, U. Gembruch, C. R. Harman

Research output: Contribution to journalArticle

Abstract

Objective: Multi-vessel Doppler ultrasonography and biophysical profile scoring (BPS) are used in the surveillance of growth restricted fetuses (IUGR). The interpretation of both tests performed concurrently may be complex. This study examines the relationship between Doppler ultrasonography and biophysical test results in IUGR fetuses. Methods: Three hundred and twenty-eight IUGR fetuses (abdominal circumference 2 SD below mean for gestational age); and (3) abnormal DV (PI > 2 SD above the mean for gestational age) and BPS groups: (1) normal (> 6/10); (2) equivocal (6/10); and (3) abnormal (<6/10). Predictions of short-term perinatal outcomes by both modalities were compared for stratification. The distribution and concordance of Doppler and BPS test results were examined for the whole patient group and based on delivery prior to 32 weeks' gestation. Results: Abnormal UA Doppler results alone were observed in 109 fetuses (33.2%), brain sparing in 87 (26.5%) and an abnormal DV in 132 (40.2%). The BPS was normal in 158 (48.2%), equivocal in 68 (20.7%) and abnormal in 102 (31.1%). Both testing modalities stratified patients into groups with comparable acid-base disturbance and perinatal outcome. Of the nine possible test combinations the largest subgroups were: abnormal UA alone/normal BPS (n = 69; 21%) and abnormal DV Doppler/abnormal BPS (n = 62; 18.9%). Assessment of compromise by both testing modalities was concordant in 146 (44.5%) cases. In 182 fetuses with discordant results the BPS grade was better in 115 (63.2%, P <0.0001). Marked disagreement of test abnormality was present in 57 (17.4%) fetuses. Of these, abnormal venous Doppler in the presence of a normal BPS constituted the largest group (Chi-square P <0.002). Stratification was not significantly different in patients delivered prior to 32 weeks' gestation. Conclusion: Doppler ultrasonography and BPS effectively stratify IUGR fetuses into risk categories, but Doppler and BPS results do not show a consistent relationship with each other. Since fetal deterioration appears to be independently reflected in these two testing modalities further research is warranted to investigate how they are best combined.

Original languageEnglish (US)
Pages (from-to)41-47
Number of pages7
JournalUltrasound in Obstetrics and Gynecology
Volume27
Issue number1
DOIs
StatePublished - Jan 2006
Externally publishedYes

Fingerprint

scoring
fetuses
Fetus
Fetal Growth Retardation
Doppler Ultrasonography
Growth
profiles
Gestational Age
stratification
Pregnancy
circumferences
abnormalities
surveillance
subgroups
deterioration
brain
vessels
Acids
grade
delivery

Keywords

  • Biophysical profile
  • Doppler
  • Integrated fetal testing
  • IUGR
  • Test results

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Acoustics and Ultrasonics

Cite this

Doppler and biophysical assessment in growth restricted fetuses : Distribution of test results. / Baschat, Ahmet; Galan, H. L.; Bhide, A.; Berg, C.; Kush, M. L.; Oepkes, D.; Thilaganathan, B.; Gembruch, U.; Harman, C. R.

In: Ultrasound in Obstetrics and Gynecology, Vol. 27, No. 1, 01.2006, p. 41-47.

Research output: Contribution to journalArticle

Baschat, A, Galan, HL, Bhide, A, Berg, C, Kush, ML, Oepkes, D, Thilaganathan, B, Gembruch, U & Harman, CR 2006, 'Doppler and biophysical assessment in growth restricted fetuses: Distribution of test results', Ultrasound in Obstetrics and Gynecology, vol. 27, no. 1, pp. 41-47. https://doi.org/10.1002/uog.2657
Baschat, Ahmet ; Galan, H. L. ; Bhide, A. ; Berg, C. ; Kush, M. L. ; Oepkes, D. ; Thilaganathan, B. ; Gembruch, U. ; Harman, C. R. / Doppler and biophysical assessment in growth restricted fetuses : Distribution of test results. In: Ultrasound in Obstetrics and Gynecology. 2006 ; Vol. 27, No. 1. pp. 41-47.
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AU - Kush, M. L.

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N2 - Objective: Multi-vessel Doppler ultrasonography and biophysical profile scoring (BPS) are used in the surveillance of growth restricted fetuses (IUGR). The interpretation of both tests performed concurrently may be complex. This study examines the relationship between Doppler ultrasonography and biophysical test results in IUGR fetuses. Methods: Three hundred and twenty-eight IUGR fetuses (abdominal circumference 2 SD below mean for gestational age); and (3) abnormal DV (PI > 2 SD above the mean for gestational age) and BPS groups: (1) normal (> 6/10); (2) equivocal (6/10); and (3) abnormal (<6/10). Predictions of short-term perinatal outcomes by both modalities were compared for stratification. The distribution and concordance of Doppler and BPS test results were examined for the whole patient group and based on delivery prior to 32 weeks' gestation. Results: Abnormal UA Doppler results alone were observed in 109 fetuses (33.2%), brain sparing in 87 (26.5%) and an abnormal DV in 132 (40.2%). The BPS was normal in 158 (48.2%), equivocal in 68 (20.7%) and abnormal in 102 (31.1%). Both testing modalities stratified patients into groups with comparable acid-base disturbance and perinatal outcome. Of the nine possible test combinations the largest subgroups were: abnormal UA alone/normal BPS (n = 69; 21%) and abnormal DV Doppler/abnormal BPS (n = 62; 18.9%). Assessment of compromise by both testing modalities was concordant in 146 (44.5%) cases. In 182 fetuses with discordant results the BPS grade was better in 115 (63.2%, P <0.0001). Marked disagreement of test abnormality was present in 57 (17.4%) fetuses. Of these, abnormal venous Doppler in the presence of a normal BPS constituted the largest group (Chi-square P <0.002). Stratification was not significantly different in patients delivered prior to 32 weeks' gestation. Conclusion: Doppler ultrasonography and BPS effectively stratify IUGR fetuses into risk categories, but Doppler and BPS results do not show a consistent relationship with each other. Since fetal deterioration appears to be independently reflected in these two testing modalities further research is warranted to investigate how they are best combined.

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