The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus
Background: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in...
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| Format: | Article |
| Language: | English |
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Al-Azhar University, Faculty of Medicine (Damietta)
2020-10-01
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| Series: | International Journal of Medical Arts |
| Subjects: | |
| Online Access: | https://ijma.journals.ekb.eg/article_111019_019f7b73104de21488f2f127cdfba0bf.pdf |
| _version_ | 1818431132557901824 |
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| author | Muhamed Ahmed Al Bellehy Khattab Abdelhaleem Omar Samia Eid Abdelrahman Emam |
| author_facet | Muhamed Ahmed Al Bellehy Khattab Abdelhaleem Omar Samia Eid Abdelrahman Emam |
| author_sort | Muhamed Ahmed Al Bellehy |
| collection | DOAJ |
| description | Background: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR. Patients and Methods: Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome. Results: There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission]. Conclusion: AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR. |
| first_indexed | 2024-12-14T15:44:27Z |
| format | Article |
| id | doaj.art-6f98f27d5ce04fb28e577f733175f95f |
| institution | Directory Open Access Journal |
| issn | 2636-4174 2682-3780 |
| language | English |
| last_indexed | 2024-12-14T15:44:27Z |
| publishDate | 2020-10-01 |
| publisher | Al-Azhar University, Faculty of Medicine (Damietta) |
| record_format | Article |
| series | International Journal of Medical Arts |
| spelling | doaj.art-6f98f27d5ce04fb28e577f733175f95f2022-12-21T22:55:32ZengAl-Azhar University, Faculty of Medicine (Damietta)International Journal of Medical Arts2636-41742682-37802020-10-012488689710.21608/ijma.2020.37083.1151111019The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic IsthmusMuhamed Ahmed Al Bellehy0Khattab Abdelhaleem Omar1Samia Eid2Abdelrahman Emam3Department of Obstetrics and Gynecology, Nabrouh General Hospital, Ministry of Health, EgyptDepartment of Obstetrics and Gynecology Damietta Faculty of Medicine, Al-Azhar University, EgyptDepartment of Obstetrics and Gynecology Damietta Faculty of Medicine, Al-Azhar University, EgyptDepartment of Obstetrics and Gynecology Damietta Faculty of Medicine, Al-Azhar University, EgyptBackground: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR. Patients and Methods: Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome. Results: There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission]. Conclusion: AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR.https://ijma.journals.ekb.eg/article_111019_019f7b73104de21488f2f127cdfba0bf.pdfdoppler ultrasoundintrauterine growth restrictionmyocardial performance indexisthmic flow indexaortic isthmus |
| spellingShingle | Muhamed Ahmed Al Bellehy Khattab Abdelhaleem Omar Samia Eid Abdelrahman Emam The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus International Journal of Medical Arts doppler ultrasound intrauterine growth restriction myocardial performance index isthmic flow index aortic isthmus |
| title | The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus |
| title_full | The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus |
| title_fullStr | The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus |
| title_full_unstemmed | The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus |
| title_short | The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus |
| title_sort | prediction of adverse perinatal outcomes in intrauterine growth restriction using the doppler indices of myocardial performance and aortic isthmus |
| topic | doppler ultrasound intrauterine growth restriction myocardial performance index isthmic flow index aortic isthmus |
| url | https://ijma.journals.ekb.eg/article_111019_019f7b73104de21488f2f127cdfba0bf.pdf |
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