Death and severe morbidity in isolated periviable small-for-gestational-age fetuses

Objective This study aims to predict perinatal death or severe sequelae in isolated small-for-gestational-age fetuses, diagnosed at a periviable gestational age, based on ultrasound and Doppler parameters at diagnosis. Design Observational study. Setting A tertiary perinatal centre. Population A coh...

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Autores: Meler, E, Mazarico, E, Peguero, A, Gonzalez, A, Martinez, J, Boada, D, Vellve, K, Arca, G, Gomez-Roig, MD, Gratacos, E, Figueras, F
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Recursos:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p21422
Acesso em linha:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21422
Access Level:acceso abierto
Palavra-chave:fetal growth restriction
neonatal complications
neurological impairment
perinatal mortality
placental insufficiency
small for gestational age
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spelling Death and severe morbidity in isolated periviable small-for-gestational-age fetusesMeler, EMazarico, EPeguero, AGonzalez, AMartinez, JBoada, DVellve, KArca, GGomez-Roig, MDGratacos, EFigueras, Ffetal growth restrictionneonatal complicationsneurological impairmentperinatal mortalityplacental insufficiencysmall for gestational ageObjective This study aims to predict perinatal death or severe sequelae in isolated small-for-gestational-age fetuses, diagnosed at a periviable gestational age, based on ultrasound and Doppler parameters at diagnosis. Design Observational study. Setting A tertiary perinatal centre. Population A cohort of singleton non-malformed fetuses suspected to be small for gestational age (estimated fetal weight, EFW, <10th centile) diagnosed at 22.0-25.6 weeks of gestation. The following parameters were recorded at diagnosis: severe smallness (<3rd centile); absent or reversed end-diastolic velocity in umbilical artery; abnormal middle cerebral artery Doppler; abnormal cerebroplacental ratio; abnormal uterine artery Doppler; and absent or reversed end-diastolic velocity in the ductus venosus. Methods Logistic regression analysis. Main outcome measures Predictive performance of EFW and Doppler parameters for short-term adverse outcome of perinatal morbimortality and composite serious adverse outcomes (death, neurological impairment or severe bronchopulmonary dysplasia). Results A total of 155 pregnancies were included. There were 13 (8.4%) intrauterine and 11 (7.7%) neonatal deaths. A short-term adverse perinatal outcome occurred in 40 (25.8%) pregnancies. There were 31 (20%) cases of serious adverse outcomes. For the prediction of serious adverse outcomes, the combination of absent or reversed end-diastolic velocity in the umbilical artery and impaired middle cerebral artery detected by Doppler evaluation achieved a detection rate of 87%, with a false-positive rate of 14% (accuracy 86%). Conclusion In periviable isolated small-for-gestational-age fetuses, a Doppler evaluation of the umbilical and fetal brain circulation can accurately predict short-term adverse perinatal complications and serious adverse outcomes.WILEY2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21422BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGYISSN: 14700328ISSNe: 14710528reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p214222026-05-27T12:37:41Z
dc.title.none.fl_str_mv Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
title Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
spellingShingle Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
Meler, E
fetal growth restriction
neonatal complications
neurological impairment
perinatal mortality
placental insufficiency
small for gestational age
title_short Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
title_full Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
title_fullStr Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
title_full_unstemmed Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
title_sort Death and severe morbidity in isolated periviable small-for-gestational-age fetuses
dc.creator.none.fl_str_mv Meler, E
Mazarico, E
Peguero, A
Gonzalez, A
Martinez, J
Boada, D
Vellve, K
Arca, G
Gomez-Roig, MD
Gratacos, E
Figueras, F
author Meler, E
author_facet Meler, E
Mazarico, E
Peguero, A
Gonzalez, A
Martinez, J
Boada, D
Vellve, K
Arca, G
Gomez-Roig, MD
Gratacos, E
Figueras, F
author_role author
author2 Mazarico, E
Peguero, A
Gonzalez, A
Martinez, J
Boada, D
Vellve, K
Arca, G
Gomez-Roig, MD
Gratacos, E
Figueras, F
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv fetal growth restriction
neonatal complications
neurological impairment
perinatal mortality
placental insufficiency
small for gestational age
topic fetal growth restriction
neonatal complications
neurological impairment
perinatal mortality
placental insufficiency
small for gestational age
description Objective This study aims to predict perinatal death or severe sequelae in isolated small-for-gestational-age fetuses, diagnosed at a periviable gestational age, based on ultrasound and Doppler parameters at diagnosis. Design Observational study. Setting A tertiary perinatal centre. Population A cohort of singleton non-malformed fetuses suspected to be small for gestational age (estimated fetal weight, EFW, <10th centile) diagnosed at 22.0-25.6 weeks of gestation. The following parameters were recorded at diagnosis: severe smallness (<3rd centile); absent or reversed end-diastolic velocity in umbilical artery; abnormal middle cerebral artery Doppler; abnormal cerebroplacental ratio; abnormal uterine artery Doppler; and absent or reversed end-diastolic velocity in the ductus venosus. Methods Logistic regression analysis. Main outcome measures Predictive performance of EFW and Doppler parameters for short-term adverse outcome of perinatal morbimortality and composite serious adverse outcomes (death, neurological impairment or severe bronchopulmonary dysplasia). Results A total of 155 pregnancies were included. There were 13 (8.4%) intrauterine and 11 (7.7%) neonatal deaths. A short-term adverse perinatal outcome occurred in 40 (25.8%) pregnancies. There were 31 (20%) cases of serious adverse outcomes. For the prediction of serious adverse outcomes, the combination of absent or reversed end-diastolic velocity in the umbilical artery and impaired middle cerebral artery detected by Doppler evaluation achieved a detection rate of 87%, with a false-positive rate of 14% (accuracy 86%). Conclusion In periviable isolated small-for-gestational-age fetuses, a Doppler evaluation of the umbilical and fetal brain circulation can accurately predict short-term adverse perinatal complications and serious adverse outcomes.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21422
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=21422
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
ISSN: 14700328
ISSNe: 14710528
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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