Geç Başlangıçlı Fetal Büyüme Geriliğinde Fetal Femoral Arter Doppler Değerlendirmesi: Vaka Kontrol Çalışması

Öz

Amaç: Femoral arter ve diğer ultrasonografik Doppler ölçümlerini geç başlangıçlı fetal büyüme geriliği olan fetüsler ile komplike olmayan fetüsler arasında karşılaştırmak. Gereç ve yöntem: Bu prospektif kohort çalışması geç başlangıçlı fetal gelişme geriliği saptanan 83 çalışma grubu gebe ile benzer gebelik haftasına sahip 85 komplike olmayan kontrol grubu gebe dahil olmak üzere 168 hasta ile gerçekleştirilmiştir. Aynı zamanda yenidoğan yoğun bakım ünitesi gereksinimine göre çalışma grubu ikiye ayrıldı. Gruplar arasında demografik özellikler, obstetrik özellikler, femoral arter ve diğer ultrasonografik doppler ölçümleri ve gebelik sonuçları karşılaştırıldı. Bulgular: Uterin arter pulsatilite indeksi, umbilikal arter sistolik/diyastolik oranı ve orta serebral arterin pik sistolik hızı çalışma ve kontrol grupları arasında benzerdi. Ancak çalışma grubunda orta serebral arter pulsatilite indeksi anlamlı olarak düşük bulunurken, femoral arter pulsatilite indeksi anlamlı olarak yüksekti (sırasıyla, p<0.001 ve p=0.002). Çalışma grubunda yenidoğan yoğun bakım ünitesi gereksinimine göre iki grup karşılaştırıldığında femoral arter ve diğer doppler ölçümleri benzer izlendi. Tahmini fetal ağırlık, yenidoğan yoğun bakım ünitesi gerektiren grupta istatistiksel olarak daha düşüktü (p=0,033). Sonuç: Geç başlangıçlı fetal büyüme geriliği olgularında femoral arter pulsatilite indeksi sağlıklı kontrollere göre daha yüksekti. Femoral arterin Doppler incelemesinin olumsuz perinatal sonuçları göstermede etkili olmadığı bulundu.

Anahtar Kelimeler

• femoral arter doppler
• fetal büyüme geriliği
• olumsuz perinatal sonuçlar
• serebroplasental oran.

Fetal Femoral Artery Doppler Evaluation in Late-Onset Fetal Growth Restriction: A Case-Control Study

Öz

Objective: To compare the femoral artery and other ultrasonographic Doppler measurements between fetuses with late-onset fetal growth restriction and uncomplicated fetuses. Material and method: This prospective cohort study was conducted with 168 patients, including 83 pregnancies presenting with late-onset fetal growth restriction and 85 uncomplicated control pregnancies at similar gestational weeks. The study group was further divided into two according to the neonatal intensive care unit requirements. Demographic characteristics, obstetric characteristics, femoral artery and other ultrasonographic Doppler measurements, and pregnancy outcomes were compared between the groups. Results: Uterine artery pulsatility index, umbilical artery systolic/diastolic ratio, and peak systolic velocity of the middle cerebral artery were similar between the study and control groups. However, while the middle cerebral artery pulsatility index was significantly lower in the study group, the femoral artery pulsatility index value was significantly higher (p<0.001 and p=0.002, respectively). When the two subgroups of the study group were compared according to the neonatal intensive care unit requirements, their femoral artery and other Doppler measurements were similar. Estimated fetal weight was statistically lower in the group requiring neonatal intensive care unit (p=0.033). Conclusion: The femoral artery pulsatility index measurement was higher in the late-onset fetal growth restriction cases than in the healthy controls. The Doppler examination of the femoral artery was not found to be effective in demonstrating adverse perinatal outcomes.

Anahtar Kelimeler

• adverse perinatal outcomes
• cerebroplacental ratio
• femoral artery doppler
• fetal growth restriction.

Kaynakça

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