Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study.

IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Iranian Journal of Medical Sciences Pub Date : 2024-10-01 DOI:10.30476/ijms.2024.100177.3231
Azam Faraji, Fereshteh Gharibpour, Niloofar Namazi, Ali Mohammad Shakiba, Maryam Kasraeian, Nasrin Asadi, Homeira Vafaei, Marjan Zare, Khadijeh Bazrafshan, Zahra Oveisi
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引用次数: 0

Abstract

Background: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses.

Methods: This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher's exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden's Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests.

Results: FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased.

Conclusion: UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.

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将卵圆孔搏动指数作为发育异常胎儿的早期受影响多普勒研究:基于前瞻性研究的最新实践启示。
背景:常规多普勒检查是早期诊断胎儿生长受限(FGR)和小于胎龄(SGA)患者的常用工具。该研究旨在确定卵圆孔脉动指数(FOPI)研究在 FGR 和 SGA 胎儿患者常规多普勒检查中的作用:这项前瞻性研究针对 35 名 FGR 胎儿、32 名 SGA 胎儿和 33 名适合妊娠年龄(AGA)胎儿。研究记录了人口统计学数据、羊水指数、新生儿结局以及多普勒速度测量,包括脐动脉脉动指数(UMAPI)、子宫动脉脉动指数(UTAPI)、大脑中动脉脉动指数(MCAPI)、静脉导管脉动指数(DVPI)和FOPI。采用 Kolmogorov-Smirnov 正态性检验、单因素方差分析、Mann-Whitney U、Kruskal-Wallis、经 Bonferroni 校正的非参数配对比较、Pearson 相关性检验、Chi 平方、费雪精确检验和用 Youden 指数(敏感性+特异性-1)估计临界点的接收者工作特征曲线(ROC)分析对数据进行显著性水平分析 结果:预测 FGR 和 SGA 的 FOPI 临界点分别为 2.24(灵敏度=77%,特异度=94%)和 1.15(灵敏度=90%,特异度=20%)。FOPI 与 UMAPI 和 UTAPI 呈正相关(r=0.52 和 r=0.30):建议使用 UMAPI 预测新生儿短期内的发病情况,并显示 FGR 发病的早晚。此外,建议将 FOPI 作为检测生长速度异常的一线多普勒检查。还需要进行更多的研究,尤其是考虑到新生儿的长期发病率。
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来源期刊
Iranian Journal of Medical Sciences
Iranian Journal of Medical Sciences MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
0.00%
发文量
84
审稿时长
12 weeks
期刊介绍: The Iranian Journal of Medical Sciences (IJMS) is an international quarterly biomedical publication, which is sponsored by Shiraz University of Medical Sciences. The IJMS intends to provide a scientific medium of com­muni­cation for researchers throughout the globe. The journal welcomes original clinical articles as well as clinically oriented basic science re­search experiences on prevalent diseases in the region and analysis of various regional problems.
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