Wang Ling, Zhou Dan, Long Baiguo, Wang Jiqing, Li Lingling, Peng Yang, Zhou Qichang, Zeng Shi
Department of Ultrasound, Women and Children Healthcare Hospital of Zhu Zhou, Zhuzhou, China.
Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, China.
Front Pediatr. 2023 Mar 10;11:1036359. doi: 10.3389/fped.2023.1036359. eCollection 2023.
This study aims to observe the changes of the umbilical venous-arterial index (VAI) and investigate its predictive power for fetal outcome during the second half of pregnancy.
Fetuses with gestational age (GA) at 24-39 weeks were collected. According to the outcome score, neonates with outcome scores of 0, 1, or 2 were assigned to the control group, whereas those with scores of 3-12 were assigned to the compromised group. VAI was calculated as the ratio of normalized umbilical vein blood flow volume and umbilical artery pulsatility index. Regression analysis was performed to obtain the best-fitting curves between VAI and GA in the controls. Doppler parameters and perinatal outcomes were compared in both groups. Receiver operating characteristic analysis was used to assess the diagnostic performance of the VAI.
A total of 833 (95%) fetuses had Doppler parameters and pregnancy outcomes documented. Compared with the controls, the VAI was significantly lower in the compromised group (83.2 vs. 184.8 ml/min/kg, < 0.001). The sensitivity and specificity of VAI to predict compromised neonates were 95.15% (95% Cl, 89.14 to 97.91%) and 99.04% (95% CI: 98.03 to 99.53%), respectively at a cutoff value of 120 ml/min/kg.
VAI presents better diagnostic performance than umbilical vein blood flow volume and umbilical artery pulsatility index. A cutoff value of 120 ml/min/kg might be used as the warning value for predicting the fetal outcome.
本研究旨在观察脐静脉 - 动脉指数（VAI）的变化，并探讨其在妊娠后半期对胎儿结局的预测能力。
收集孕周为24 - 39周的胎儿。根据结局评分，结局评分为0、1或2的新生儿被分配到对照组，而评分在3 - 12分的新生儿被分配到不良组。VAI计算为标准化脐静脉血流量与脐动脉搏动指数的比值。进行回归分析以获得对照组中VAI与孕周之间的最佳拟合曲线。比较两组的多普勒参数和围产期结局。采用受试者工作特征分析来评估VAI的诊断性能。
共有833例（95%）胎儿记录了多普勒参数和妊娠结局。与对照组相比，不良组的VAI显著降低（83.2对184.8 ml/min/kg，<0.001）。在截断值为120 ml/min/kg时，VAI预测不良新生儿的敏感性和特异性分别为95.15%（95%CI，89.14至97.91%）和99.04%（95%CI：98.03至99.53%）。
VAI比脐静脉血流量和脐动脉搏动指数具有更好的诊断性能。截断值120 ml/min/kg可作为预测胎儿结局的警示值。
