Dopplervelocimetria do ducto venoso na predição da acidemia fetal
Autor(a) principal: | |
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Data de Publicação: | 2005 |
Outros Autores: | , , , , , , |
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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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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1814268374885072896 |