Altered arterial doppler flow pattern and perinatal outcome in intrauterine growth restriction

Krishnananda Nayak, Pratap Kumar, Ranjan Shetty, Kiran Kumar Shetty, Jyothi, Leslie Edward Lewis, Shreemathi S. Maiyya

Research output: Contribution to journalArticle

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Abstract

Objectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15% of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limited data available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study the perinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age. Methods: This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was made according to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuses with healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography (ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at south Indian tertiary care center. Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGR groups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was not evident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamber quantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than the control group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group, whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among two groups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGR group also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001). Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverse perinatal outcome. This study showed significant perinatal mortality accounting for 5.6% among IUGR cases when compared to normal. Although tissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared to severe form of IUGR subsets who show altered tissue annular velocities.

Original languageEnglish
Pages (from-to)425-428
Number of pages4
JournalAsian Journal of Pharmaceutical and Clinical Research
Volume10
Issue number3
DOIs
Publication statusPublished - 01-03-2017

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Growth
Gestational Age
Fetus
Perinatal Mortality
Echocardiography
Pregnancy
Neonatal Intensive Care Units
Incidence
Transducers
Prenatal Diagnosis
Mitral Valve
Practice Guidelines
Tertiary Care Centers
Abdomen
Pulmonary Artery
Pregnant Women
Cohort Studies
Head
Mothers
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmaceutical Science
  • Pharmacology (medical)

Cite this

@article{153a01802e9b4e838abc858d0d1594a3,
title = "Altered arterial doppler flow pattern and perinatal outcome in intrauterine growth restriction",
abstract = "Objectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15{\%} of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limited data available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study the perinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age. Methods: This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was made according to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuses with healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography (ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at south Indian tertiary care center. Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGR groups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was not evident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamber quantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than the control group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group, whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among two groups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGR group also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001). Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverse perinatal outcome. This study showed significant perinatal mortality accounting for 5.6{\%} among IUGR cases when compared to normal. Although tissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared to severe form of IUGR subsets who show altered tissue annular velocities.",
author = "Krishnananda Nayak and Pratap Kumar and Ranjan Shetty and Shetty, {Kiran Kumar} and Jyothi and Lewis, {Leslie Edward} and Maiyya, {Shreemathi S.}",
year = "2017",
month = "3",
day = "1",
doi = "10.22159/ajpcr.2017.v10i3.16422",
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Altered arterial doppler flow pattern and perinatal outcome in intrauterine growth restriction. / Nayak, Krishnananda; Kumar, Pratap; Shetty, Ranjan; Shetty, Kiran Kumar; Jyothi, ; Lewis, Leslie Edward; Maiyya, Shreemathi S.

In: Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, No. 3, 01.03.2017, p. 425-428.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Altered arterial doppler flow pattern and perinatal outcome in intrauterine growth restriction

AU - Nayak, Krishnananda

AU - Kumar, Pratap

AU - Shetty, Ranjan

AU - Shetty, Kiran Kumar

AU - Jyothi,

AU - Lewis, Leslie Edward

AU - Maiyya, Shreemathi S.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Objectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15% of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limited data available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study the perinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age. Methods: This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was made according to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuses with healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography (ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at south Indian tertiary care center. Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGR groups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was not evident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamber quantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than the control group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group, whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among two groups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGR group also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001). Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverse perinatal outcome. This study showed significant perinatal mortality accounting for 5.6% among IUGR cases when compared to normal. Although tissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared to severe form of IUGR subsets who show altered tissue annular velocities.

AB - Objectives: Intrauterine growth restriction (IUGR) is one of the common conditions that interfere with the growth of the fetus accounting for 10-15% of pregnant woman. Literature explores a wide range of incidence of perinatal complication including mortality among IUGR pregnancies. Limited data available on these complications confined to coastal Karnataka and its association with abnormal arterial Doppler flow pattern. To study the perinatal complications associated with IUGR pregnancies and its prevalence in comparison to healthy controls of comparable gestational age. Methods: This cohort study screened 53 IUGR fetuses by an antenatal scan at gestational age of 27 weeks or more. The diagnosis of IUGR was made according to established criteria from SOGC clinical practice guidelines August 2013. The data also included 48 appropriate for gestational age fetuses with healthy mothers with the comparable gestational week. Experienced cardiac sonographer and gynecologist performed fetal echocardiography (ECHO) using Vivid 7, GE health-care system ECHO machine with the convex transducer of frequency 1.7-2.4 MHz. The study was conducted at south Indian tertiary care center. Results: This study included 53 IUGR cases and 48 non-IUGR controls. The mean age was 27±4.37 and 26.88±3.14 years in IUGR and non-IUGR groups, respectively. Fetal Doppler study variables showed a significant decrease in peak aortic velocity and velocity time integral which was not evident on other valves, though mitral antegrade flow during atrial contraction was found to be lower among IUGR group. In two-dimensional chamber quantification of IUGR group revealed significant increase in pulmonary artery dimension, right ventricular (RV) dimension and RV thickness than the control group (p<0.05). The anthropometric parameters such as weight and length; abdomen circumference was significantly lower in IUGR group, whereas head circumference found to be more in IUGR group (p<0.001). The gestational weeks at delivery was significantly different among two groups with IUGR group depicting the early delivery group. p<0.001(35.58±2.92 and 38.5±0.96 in IUGR and non-IUGR groups, respectively). IUGR group also had prolonged neonatal intensive care unit stay when compared to controls (p<0.001). Conclusions: IUGR carries profound course in altered Doppler indices and cardiac function which explore its prediction on mortality and adverse perinatal outcome. This study showed significant perinatal mortality accounting for 5.6% among IUGR cases when compared to normal. Although tissue Doppler indices show normal variants, IUGR possesses significant adverse perinatal outcome, however with lesser incidence compared to severe form of IUGR subsets who show altered tissue annular velocities.

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