[The importance of measuring both umbilical arteries for accuracy in Doppler ultrasound studies].

H Jörn, I Scheffen, H Fendel, A Funk
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Abstract

In a quarter of our Doppler investigations differences between the S/D-ratios of the arteries of one umbilical cord were more than 20%. In these cases one Doppler value was decided to be normal and the other to be pathological. In cases with two pathological values most caesarean sections because of fetal distress had to be performed and most SGA babies were born. There were relatively more caesarean sections and SGA babies in cases with one normal value and one pathological value than in cases with two normal Doppler values. Sensitivity and specificity of perinatal risks like intrauterine growth retardation or caesarean section because of fetal distress were different depending on which Doppler value was used to calculate these statistical parameters. Taking always the better values compared to the worse ones we found as greatest difference 20.0% for sensitivities and 24.1% for specificities. Taking the means of the better and the worse Doppler values we found as greatest difference 5.6% for sensitivities and 8.7% for specificities compared to the cases with two identical Doppler results. To decide whether the fetus is jeopardized and to describe the nutritional function of the placenta correctly by means of Doppler ultrasound of the umbilical artery we conclude that in some cases the investigation of both arteries is important to avoid false positive or false negative results.

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[在多普勒超声研究中测量双脐动脉的准确性的重要性]。
在我们四分之一的多普勒调查中,一条脐带动脉的S/ d比差异超过20%。在这些病例中,一个多普勒值被认为是正常的,另一个被认为是病态的。在有两种病理值的病例中,由于胎儿窘迫,大多数剖腹产手术必须进行,大多数SGA婴儿出生。一个正常值和一个病理值的剖宫产率高于两个正常多普勒值的剖宫产率。不同的多普勒值计算这些统计参数,对宫内生长迟缓或因胎儿窘迫而剖宫产等围产期风险的敏感性和特异性不同。总是取较好的值与较差的值相比,我们发现敏感性和特异性的最大差异为20.0%和24.1%。采用较好和较差多普勒值的方法,我们发现与两个相同多普勒结果的病例相比,敏感性差异为5.6%,特异性差异为8.7%。为了确定胎儿是否受到危害,并正确描述胎盘的营养功能,通过多普勒超声脐动脉我们得出结论,在某些情况下,调查两个动脉是重要的,以避免假阳性或假阴性结果。
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[Symposium on Uterine Contraction and Beginning of Labor. Aachen, September 1993]. [Uterine contraction and labor onset. Overview]. [Control of labor onset in the human]. [Biochemical principles of cervix ripening and dilatation]. [Role of the cervix uteri at labor onset from ultrasound studies].
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