Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
Prenat Diagn. 2012 Oct;32(10):960-7. doi: 10.1002/pd.3941. Epub 2012 Jul 23.
To determine the association between Doppler changes in the fetal vertebral (VA), middle cerebral (MCA), and umbilical arteries (UA) and severity of growth restriction (FGR) in fetuses delivered after 34 weeks.
Five hundred seventy-one Doppler examinations of the VA, MCA, and UA were performed between 26 and 41 weeks of gestation. Values were converted into multiples of the median and divided into birth weight (BW) categories: BW>P10(th) , BW<P10(th) , BW<P5 th, and BW<P3(rd) . Differences were evaluated and multivariate logistic regression models plus receiver-operating characteristic curves were calculated to determine the accuracy of Doppler measurements for the prediction of FGR percentiles.
The UA pulsatility index (PI) was significant predicting BW<P10(th) and BW<P3(rd) , the VA PI was significant predicting BW<P5(th) and BW<P3(rd) . Finally, the MCA PI was not predictive of any degree of severity of FGR. In addition, only VA and UA differences were statistically significant.
In fetuses delivered after 34 weeks, mild degrees of growth restriction are better associated with high UA PI whereas severe degrees are associated with low VA PI but not with low MCA PI.
探讨孕 34 周后分娩胎儿胎儿椎动脉（VA）、大脑中动脉（MCA）和脐动脉（UA）多普勒变化与生长受限（FGR）严重程度的关系。
对 26 至 41 周妊娠的 571 例 VA、MCA 和 UA 多普勒检查进行分析。将数值转换为中位数倍数，并按出生体重（BW）分类：BW>P10(th)、BW<P10(th)、BW<P5 th 和 BW<P3(rd)。评估差异，并计算多元逻辑回归模型和接收者操作特征曲线，以确定多普勒测量对预测 FGR 百分位数的准确性。
UA 搏动指数（PI）对预测 BW<P10(th)和 BW<P3(rd)有显著意义，VA PI 对预测 BW<P5(th)和 BW<P3(rd)有显著意义。MCA PI 不能预测任何程度的 FGR 严重程度。此外，只有 VA 和 UA 的差异具有统计学意义。
在孕 34 周后分娩的胎儿中，轻度生长受限与较高的 UA PI 相关，而严重的生长受限与较低的 VA PI 相关，与较低的 MCA PI 无关。
