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22nd World Congress on Ultrasound in Obstetrics and Gynecology Poster abstracts

newborn, umbilical artery power Doppler with zero or reverse P08.16
enddiastolic blood flow (blood flow class IIIa/IIIb) or changes in Perinatal outcome of late-onset small-for-gestational-age
venous duct blood flow. We collected data about pregnancy, prenatal foetuses with abnormal middle cerebral artery Doppler
ultrasound examinations and result of pregnancy. fluxometry: preliminary results
Results: 20 pregnancies were included. All women underwent caesar- E. Baptista, A. Domingues, E. Marta, P. Moura
ian section. Indication was severe maternal complication, worsening
of power Doppler or deterioration of the fetus. 4 children died Obstetrics, Coimbra University Hospital, Coimbra, Portugal
in postnatal period, 3 have some birth defects. Mean time of first
ultrasound was 29+2g.w.11 fetuses had zero flow and 6 had reverse Objectives: To present the preliminary results of a study that aims to
enddiastolic blood flow in umbilical artery. Mean estimated body evaluate the perinatal outcome of late-onset (> 32 weeks) small-for-
weight was on 4.1th centile, mean pulsatile index in umbilical artery gestational-age (SGA) foetuses with normal umbilical artery (UA)
2.39 (SD0.32) and cerebroplacental ratio 0.65 (SD0.18). Mean ges- Doppler velocimetry but abnormal middle cerebral artery (MCA)
tation week at delivery 29+5g.w, fetal body weight 891 g, Apgar pulsatility index (PI).
score at 5th min 8, 10th min 9, arterial pH7.25 (SD1.69) and venous Methods: Retrospective assessment of all singleton late-onset
pH7.3 (SD1.63). SGA foetuses with normal UA Doppler indices that had also
Conclusions: Management of perinatal care of early onset IUGR performed MCA Doppler velocimetry, between January/2010 and
with signs of blood flow redistribution is based on values of pulsatile December/2011. Those with abnormal MCA Doppler (IP < 5th
index of umbilical artery, medial cerebral artery, venous duct and its percentile) were included in group A and the ones that present
pattern. Extreme or severe prematurity and maternal hypertensive normal MCA Doppler fluxometry until last scan were included in
complication are important factors. Supported by the grant from the group B. The perinatal outcome was analyzed in both groups.
Ministry of Health of the Czech Republic IGA NT 11004-3/2010, Results: A total of 35 cases were included in this study, 3 (8.6%)
NT 12225-4/2011. in group A and 32 (91.4%) in group B. The mean gestational age
at SGA diagnosis was 33.7 (±SD 2.9) and 33.9 (±SD 2.2) weeks
in group A and B, respectively (P = n.s.), and that at delivery was
P08.15 38.0 (±SD 1.7) weeks in group A and 38.5 (±SD 1.1) weeks in
The role of uterine artery pulsatility index for prediction of group B (P = n.s.). One caesarean section was performed for ‘non-
outcome in pregnancies complicated by pre-eclampsia reassuring’ cardiotocographic tracing in group A (which presented
umbilical cord artery acidosis at birth) and four in group B (33.3%
A. Fichera, G. Pagani, V. Gerosa, M. Gregorini, P. Rovida,
vs. 12.5%; P = n.s.). The average birth weight was 2455.0 (±SD
F. Prefumo, T. Frusca
358.8) g in group A and 2487.5 (±SD 195.8) g in group B (P = n.s.)
Maternal Fetal Medicine Unit, University of Brescia, and there were no newborns with Apgar score < 4 at 1 or < 7 at 5 in
Brescia, Italy either group. The only newborn that presented significant neonatal
morbidity requiring admission in neonatal intensive care unit was
Objectives: To assess the correlation between mean artery pulsatility included in group A (33.3% vs. 0.0%; P = n.s.). No perinatal deaths
index (UtA PI), measured at diagnosis of pre-eclampsia (PE), were reported.
gestational age (GA) at delivery, and birth weight (BW) percentile. Conclusions: Although no statistical significance was found, the
To assess the predictive value of mean UtA PI for the development preliminary findings of this study show a tendency towards poorer
of adverse pregnancy outcome (APO). perinatal outcome of late-onset SGA foetuses with isolated MCA
Methods: Cohort study on 100 consecutive singleton pregnancies vasodilatation.
complicated with PE referred to our Department (2010–2011).
Mean UtA PI values obtained at the time of diagnosis of PE were
analysed. Clinical and perinatal outcomes were reviewed. APO was
defined as one of the following: Apgar score < 7 at five minutes; pH Assessment of cervical artery indices using transvaginal
< 7.20; birth weight < 5th percentile (SGA), stillbirth or neonatal ultrasound: preliminary results
death. Receiver-operating characteristics (ROC) curve calculated to
determine the predictive ability for subsequent development of APO. L. Rios, A. F. Moron, L. Nardozza, A. R. Hatanaka,
Results: Median maternal age was 32 years (IQR 27–37 yrs), E. Araujo, M. G. Martins
maternal BMI 21.9 kg/mq (IQR19.9–26.6 kg/mq), GA at diagnosis Obstetrics, UNIFESP-EPM, São Paulo, Brazil
was 31 w (IQR 29+3–32+1), GA at delivery was 34+1 w (IQR
32+2–36+2 w), BW was 1629 g (IQR 1380–2050), BW percentile Objectives: In this study we evaluated cervical artery Doppler
was 2.6th (0.5th –8.9th ), pH was 7.27 (IQR 7.23–7.29). Fifty-six velocimetry between 20 and 24 week’s gestation using transvaginal
pregnancies developed APO. One case of stillbirth and four cases of ultrasound.
neonatal death were observed. SGA occurred in 56/100 neonates. Methods: This cross-sectional study involved 54 low risk pregnant
Mean ± SD UtA PI at diagnosis of PE was 1.40 ± 0.28 in women women between 20 and 24 weeks, in wich we performed Doppler
that developed APO and 1.10 ± 0.41 in women that did not develop of cervical artery using transvaginal transducer. The image of the
APO (P = 0.02). There was a significant negative correlation between cervix was obtained by an optimal sagittal view of the cervix and
mean UtA PI and GA at delivery (r = −0.533, P = 0.002), and lower segment. The cervical artery was localized at superior portion
between mean UtA PI and BW percentile (r = −0.466, P = 0.007). of cervix. We evaluated resistance index (RI), pulsatility index (PI)
The prediction of the subsequent development of APO, expressed as and systolic/diastolic ratio (S/D). The cervical length (CL) was also
the area under ROC curve, was 61.6 (95% CI 0.44–0.79) for UtA measured and correlated with cervical artery vascular indices (RI,
PI at diagnosis of PE. PI and S/D) and Doppler assessment of the uterine arteries. For
Conclusions: Our data confirm that mean UtA PI, assessed at Statistical analysis Spearman correlation was used.
diagnosis of PE, represent a good independent predictor for GA Results: Mean gestational age (GA) was 21.6 weeks (SD, 1.3 weeks).
at delivery and BW percentile. However the predictive value for The median duration of the sonographic examinations was
the subsequent development of APO does not seem to be clinically 5.3 minutes (4–18). Funneling was noted in one case. Cervical
relevant. length was not normally distributed. The median CL was 41 mm.
Vascular indices (RI, PI and S/D) were not normally distributed
(Table 1). There were no significant correlations between cervical
artery PI, uterine artery and cervical length measurement.
Conclusions: In these preliminary results, there were no significant
correlations between cervical artery PI, uterine artery mPI and

202 Ultrasound in Obstetrics & Gynecology 2012; 40 (Suppl. 1): 171–310