Dopplervelocimetria do ducto venoso na predição da acidemia fetal

Detalhes bibliográficos
Autor(a) principal: Carvalho, Francisco Herlânio Costa [UNIFESP]
Data de Publicação: 2005
Outros Autores: Moron, Antonio Fernandes [UNIFESP], Mattar, Rosiane [UNIFESP], Santana, Renato Martins [UNIFESP], Murta, Carlos Geraldo V. [UNIFESP], Barbosa, Maurício Mendes [UNIFESP], Torloni, Maria Regina [UNIFESP], Kulay Junior, Luiz [UNIFESP]
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da UNIFESP
Texto Completo: http://dx.doi.org/10.1590/S0104-42302005000400019
http://repositorio.unifesp.br/handle/11600/2604
Resumo: OBJETIVES: To investigate the possibility of predicting acidemia at birth in pregnancies with placental insufficiency by Doppler velocimetry of the ductus venosus and to establish the best parameter and cut-off points in this prediction. METHODS: This was a prospective cross-sectional study, involving 47 single pregnancies with placental insufficiency after 26 weeks of gestation, carried out at the Hospital São Paulo (UNIFESP) and Maternidade-Escola Assis Chateaubriand (UFC). Placental insufficiency was defined as the umbilical artery pulsatility index above the 95th percentile for gestational age. Fetuses with chromosomal or structural anomalies were excluded. The time interval between the Doppler velocimetry and the birth was of less than 24 hours. The umbilical arterial blood samples were collected immediately after birth. Acidemia was defined as umbilical arterial pH < 7.2 in the absence of uterine contractions and < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth was considered pathological. Receiver operating characteristics (ROC) curves were calculated for S, D and A-velocities, pulsatility index for veins and the S/A ratio and (S-A)/S ratio of the ductus venosus. Parameters were compared using the MacNemar Test RESULTS: S, D and A-velocities of the ductus venosus were poor predictors of acidemia at birth. The pulsatility index for veins (area under the curve 0.79, p=0.003), S/A ratio and (S-A)/S ratio (area under the curve 0.818, p=0.001) of the DV were strongly related to fetal acidemia. The cut-off points calculated were: pulsatility index for veins = 0.76; S/A ratio = 2.67 and (S-A)/S ratio = 0.63. CONCLUSIONS: The angle-independent indices of the DV Doppler are adequate for the diagnosis of fetal acidemia in gestations with placental insufficiency. No statistically significant differences were observed between these parameters.
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spelling Dopplervelocimetria do ducto venoso na predição da acidemia fetalDuctus venosus Doppler velocimetry to predict acidemia at birth in pregnancies with placental insufficiencyDoppler velocimetryDuctus venosusFetal acidemiaDopplervelocimetriaDucto venosoAcidemia fetalOBJETIVES: To investigate the possibility of predicting acidemia at birth in pregnancies with placental insufficiency by Doppler velocimetry of the ductus venosus and to establish the best parameter and cut-off points in this prediction. METHODS: This was a prospective cross-sectional study, involving 47 single pregnancies with placental insufficiency after 26 weeks of gestation, carried out at the Hospital São Paulo (UNIFESP) and Maternidade-Escola Assis Chateaubriand (UFC). Placental insufficiency was defined as the umbilical artery pulsatility index above the 95th percentile for gestational age. Fetuses with chromosomal or structural anomalies were excluded. The time interval between the Doppler velocimetry and the birth was of less than 24 hours. The umbilical arterial blood samples were collected immediately after birth. Acidemia was defined as umbilical arterial pH < 7.2 in the absence of uterine contractions and < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth was considered pathological. Receiver operating characteristics (ROC) curves were calculated for S, D and A-velocities, pulsatility index for veins and the S/A ratio and (S-A)/S ratio of the ductus venosus. Parameters were compared using the MacNemar Test RESULTS: S, D and A-velocities of the ductus venosus were poor predictors of acidemia at birth. The pulsatility index for veins (area under the curve 0.79, p=0.003), S/A ratio and (S-A)/S ratio (area under the curve 0.818, p=0.001) of the DV were strongly related to fetal acidemia. The cut-off points calculated were: pulsatility index for veins = 0.76; S/A ratio = 2.67 and (S-A)/S ratio = 0.63. CONCLUSIONS: The angle-independent indices of the DV Doppler are adequate for the diagnosis of fetal acidemia in gestations with placental insufficiency. No statistically significant differences were observed between these parameters.OBJETIVOS: Investigar a possibilidade da predição da acidemia no nascimento mediante dopplervelocimetria do ducto venoso e definir qual o melhor parâmetro e seus pontos de corte nessa predição em gestações com insuficiência placentária. MÉTODOS: Trata-se de estudo transversal e prospectivo que analisou 47 gestações únicas com insuficiência placentária e idade gestacional superior a 26 semanas, realizado no Hospital São Paulo (UNIFESP) e na Maternidade-Escola Assis Chateaubriand (UFC). A insuficiência placentária foi diagnosticada quando o índice de pulsatilidade da artéria umbilical encontrava-se acima do percentil 95 para a idade gestacional estimada. Fetos com anomalias estruturais ou cromossômicas foram excluídos. O doppler foi realizado a menos de 24 horas do parto. A amostra de sangue da artéria umbilical foi coletada imediatamente após o nascimento para análise da gasometria. Diagnosticou-se acidemia quando o pH encontrava-se abaixo de 7,20 na ausência de trabalho de parto e abaixo de 7,15 quando parto vaginal. Foram consideradas patológicas as acidemias metabólicas ou mistas. Construiu-se curva ROC para as velocidades S, D e A e para o IPV e as relações S/A e (S-A)/S do DV (variáveis independentes) e acidemia (variável dependente). O teste de MacNemar foi utilizado para comparar os parâmetros entre si. RESULTADOS: As velocidades absolutas S, D e A mostraram ser pobres preditoras da acidemia no nascimento. O IPV mostrou ser bom preditor de acidemia (área sob a curva ROC 0,79, p=0,003). As relações S/A e (S-A)/S também mostraram ser boas preditoras da acidemia (área sob a curva ROC 0,818, p=0,001). Os pontos de corte calculados foram: IPV = 0,76, S/A = 2,67 e (S-A)/S = 0,63. CONCLUSÕES: Os índices ângulo-independentes do doppler do DV mostraram excelente correlação com acidemia no nascimento nesta população. Não houve diferença estatisticamene significativa entre estes parâmetros.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Hospital São PauloUniversidade Federal do Ceará Maternidade-Escola Assis ChateaubriandUNIFESP, EPM, Hospital São PauloSciELOAssociação Médica BrasileiraUniversidade Federal de São Paulo (UNIFESP)Universidade Federal do Ceará Maternidade-Escola Assis ChateaubriandCarvalho, Francisco Herlânio Costa [UNIFESP]Moron, Antonio Fernandes [UNIFESP]Mattar, Rosiane [UNIFESP]Santana, Renato Martins [UNIFESP]Murta, Carlos Geraldo V. [UNIFESP]Barbosa, Maurício Mendes [UNIFESP]Torloni, Maria Regina [UNIFESP]Kulay Junior, Luiz [UNIFESP]2015-06-14T13:31:40Z2015-06-14T13:31:40Z2005-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion221-227application/pdfhttp://dx.doi.org/10.1590/S0104-42302005000400019Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 51, n. 4, p. 221-227, 2005.10.1590/S0104-42302005000400019S0104-42302005000400019.pdf0104-4230S0104-42302005000400019http://repositorio.unifesp.br/handle/11600/2604porRevista da Associação Médica Brasileirainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T22:04:13Zoai:repositorio.unifesp.br/:11600/2604Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-29T22:04:13Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false
dc.title.none.fl_str_mv Dopplervelocimetria do ducto venoso na predição da acidemia fetal
Ductus venosus Doppler velocimetry to predict acidemia at birth in pregnancies with placental insufficiency
title Dopplervelocimetria do ducto venoso na predição da acidemia fetal
spellingShingle Dopplervelocimetria do ducto venoso na predição da acidemia fetal
Carvalho, Francisco Herlânio Costa [UNIFESP]
Doppler velocimetry
Ductus venosus
Fetal acidemia
Dopplervelocimetria
Ducto venoso
Acidemia fetal
title_short Dopplervelocimetria do ducto venoso na predição da acidemia fetal
title_full Dopplervelocimetria do ducto venoso na predição da acidemia fetal
title_fullStr Dopplervelocimetria do ducto venoso na predição da acidemia fetal
title_full_unstemmed Dopplervelocimetria do ducto venoso na predição da acidemia fetal
title_sort Dopplervelocimetria do ducto venoso na predição da acidemia fetal
author Carvalho, Francisco Herlânio Costa [UNIFESP]
author_facet Carvalho, Francisco Herlânio Costa [UNIFESP]
Moron, Antonio Fernandes [UNIFESP]
Mattar, Rosiane [UNIFESP]
Santana, Renato Martins [UNIFESP]
Murta, Carlos Geraldo V. [UNIFESP]
Barbosa, Maurício Mendes [UNIFESP]
Torloni, Maria Regina [UNIFESP]
Kulay Junior, Luiz [UNIFESP]
author_role author
author2 Moron, Antonio Fernandes [UNIFESP]
Mattar, Rosiane [UNIFESP]
Santana, Renato Martins [UNIFESP]
Murta, Carlos Geraldo V. [UNIFESP]
Barbosa, Maurício Mendes [UNIFESP]
Torloni, Maria Regina [UNIFESP]
Kulay Junior, Luiz [UNIFESP]
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Federal de São Paulo (UNIFESP)
Universidade Federal do Ceará Maternidade-Escola Assis Chateaubriand
dc.contributor.author.fl_str_mv Carvalho, Francisco Herlânio Costa [UNIFESP]
Moron, Antonio Fernandes [UNIFESP]
Mattar, Rosiane [UNIFESP]
Santana, Renato Martins [UNIFESP]
Murta, Carlos Geraldo V. [UNIFESP]
Barbosa, Maurício Mendes [UNIFESP]
Torloni, Maria Regina [UNIFESP]
Kulay Junior, Luiz [UNIFESP]
dc.subject.por.fl_str_mv Doppler velocimetry
Ductus venosus
Fetal acidemia
Dopplervelocimetria
Ducto venoso
Acidemia fetal
topic Doppler velocimetry
Ductus venosus
Fetal acidemia
Dopplervelocimetria
Ducto venoso
Acidemia fetal
description OBJETIVES: To investigate the possibility of predicting acidemia at birth in pregnancies with placental insufficiency by Doppler velocimetry of the ductus venosus and to establish the best parameter and cut-off points in this prediction. METHODS: This was a prospective cross-sectional study, involving 47 single pregnancies with placental insufficiency after 26 weeks of gestation, carried out at the Hospital São Paulo (UNIFESP) and Maternidade-Escola Assis Chateaubriand (UFC). Placental insufficiency was defined as the umbilical artery pulsatility index above the 95th percentile for gestational age. Fetuses with chromosomal or structural anomalies were excluded. The time interval between the Doppler velocimetry and the birth was of less than 24 hours. The umbilical arterial blood samples were collected immediately after birth. Acidemia was defined as umbilical arterial pH < 7.2 in the absence of uterine contractions and < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth was considered pathological. Receiver operating characteristics (ROC) curves were calculated for S, D and A-velocities, pulsatility index for veins and the S/A ratio and (S-A)/S ratio of the ductus venosus. Parameters were compared using the MacNemar Test RESULTS: S, D and A-velocities of the ductus venosus were poor predictors of acidemia at birth. The pulsatility index for veins (area under the curve 0.79, p=0.003), S/A ratio and (S-A)/S ratio (area under the curve 0.818, p=0.001) of the DV were strongly related to fetal acidemia. The cut-off points calculated were: pulsatility index for veins = 0.76; S/A ratio = 2.67 and (S-A)/S ratio = 0.63. CONCLUSIONS: The angle-independent indices of the DV Doppler are adequate for the diagnosis of fetal acidemia in gestations with placental insufficiency. No statistically significant differences were observed between these parameters.
publishDate 2005
dc.date.none.fl_str_mv 2005-08-01
2015-06-14T13:31:40Z
2015-06-14T13:31:40Z
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://dx.doi.org/10.1590/S0104-42302005000400019
Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 51, n. 4, p. 221-227, 2005.
10.1590/S0104-42302005000400019
S0104-42302005000400019.pdf
0104-4230
S0104-42302005000400019
http://repositorio.unifesp.br/handle/11600/2604
url http://dx.doi.org/10.1590/S0104-42302005000400019
http://repositorio.unifesp.br/handle/11600/2604
identifier_str_mv Revista da Associação Médica Brasileira. Associação Médica Brasileira, v. 51, n. 4, p. 221-227, 2005.
10.1590/S0104-42302005000400019
S0104-42302005000400019.pdf
0104-4230
S0104-42302005000400019
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv Revista da Associação Médica Brasileira
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 221-227
application/pdf
dc.publisher.none.fl_str_mv Associação Médica Brasileira
publisher.none.fl_str_mv Associação Médica Brasileira
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
instacron:UNIFESP
instname_str Universidade Federal de São Paulo (UNIFESP)
instacron_str UNIFESP
institution UNIFESP
reponame_str Repositório Institucional da UNIFESP
collection Repositório Institucional da UNIFESP
repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
repository.mail.fl_str_mv biblioteca.csp@unifesp.br
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