Fetal Anomalies in Pregnancies with Pathological Patterns of Umbilical Artery Doppler Velocimetry

Yıl 2014, Cilt: 11 Sayı: 2, 41 - 45, 01.04.2014

Esma Sarıkaya Özay Oral

Öz

Aim: Our aim was to evaluate the associated congenital anomalies with pathological patterns of umbilical artery Doppler absent or reversed enddiastolic velocity AREDV at a gestational age > 20 weeks. Material and Methods: Fourty four fetuses with absent n=29 or reversed n=15 end-diastolic velocity in the umbilical artery UA at a gestational age > 20 weeks were considered. Presence of chromosomal or congenital abnormalities were recorded. A computerized literature search through Medline and PubMED was performed, applying the words “congenital anomaly, umbilical artery Doppler ultrasound “ cited between the year 1987 and 2010. Results: Pathological patterns of umbilical artery doppler were most frequently encountered in subjects with significant intrauterine growth retardation IUGR associated with hypertension 68,8% , followed by IUGR alone 58,8% , and hypertensin alone 40% . In 3 of the 44 patients with AREDV in the UA, amniotic fluid index and the uterine artery waveform was normal and there were no hypertensive complications. Of these patients 1 trisomy18 2.2% , 1 congenital ichthyosis 2.2% , and 1 fetal hydrops 2.2% , were detected. So our congenital anomaly rate was 6.8% in such cases. Conclusion: In developing countries, due to poor antenatal care programs and different cultural resources regarding selective termination of pregnancies for fetal anomalies many fetuses with anomalies could reach to the third trimester of pregnancy. Genetic sonogram is essential, when pathological umbilical Doppler velocimetry patterns are associated with advanced maternal age, and absence of oligohydramnios and hypertensive complications in the management of these pregnancies.

Anahtar Kelimeler

Congenital abnormalities, Doppler

Patolojik Umbilikal Arter Doppler Akım Paterni Tesbit Edilen Gebeliklerde Görülen Fetal Anomaliler

Öz

Amaç: Çalışmamızda; 20. gestasyonel haftanın üzerinde patolojik umbilikal arter Doppler paterni diastol sonu akım kaybı veya ters akım ile birlikte görülen konjenital anomalilerin araştırılması amaçlanmıştır. Materyal ve Metod: 20. gebelik haftası üzeri umbilikal arter Doppler incelemesinde diastol sonu akım kaybı olan 29, ters akım olan 15 hasta çalışmaya dahil edilmiştir. Olgularda saptanan kromozomal ve konjenital anomaliler kaydedilmiştir. Konjenital anomali, umbilikal arter Doppler kelimeleri girilerek Medline ve PubMED de yer alan 1987 ve 2010 yıllarını kapsayan literatürler gözden geçirilmiştir. Bulgular: Umbilikal arterde patolojik Doppler akımı en sık intrauterin gelişme geriliğinin hipertansiyon ile birlikte olduğu vakalarda %68.8 sonra %58.8 sıklıkla sadece intrauterin gelişme geriliği olanlarda, %40 oranında da sadece hipertansiyon olanlarda tesbit edilmiştir. Patolojik Doppler akımı mevcut olan 44 hastanın 3’ünde amniyotik sıvı indeksi ve uterin arter dalga formları normaldi ve hipertansiyon komplikasyonu yoktu. Bu hastalardan 1 tanesinde Trizomi 18 %2.2 , 1 konjenital ihtiyoz %2.2 , ve 1 fetal hidrops %2.2 tesbit edildi. Sonuç: Gelişmekte olan ülkelerde oturmamış antenatal tarama programları ve fetal anomaliler de gebelik terminasyonuna çeşitli kültürel yaklaşımlar nedeniyle birçok anomalili bebek gebeliğin 3. trimesterine ulaşabilmektedir. Oligohidramnios ve hipertansiyon gibi komplikasyonlar yokken patolojik umbilikal arter Doppler akımı görülen özellikle ileri yaş olgularda genetik sonogram bu gebeliklerin yönetiminde gereklidir.

Anahtar Kelimeler

Doğumsal anomaliler, Doppler

Kaynakça

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