Dopplersonographische Blutflußmessung der A. umbilicalis: Ist ein Screening sinnvoll?

251 Einlingsgraviditaten mit gesichertem Gestationsalter wurden zwischen der 28. und 42. Woche p.m. dopplersonographisch untersucht. Die Flusmuster der Nabelarterien wurden durch Bestimmung der A/B-Ratio nach Stuart anhand einer eigenen Normkurve ausgewertet. Als pathologisch wurden Werte oberhalb der gestationsalterbezogenen 95. Percentile angenommen. Die Messungen wurden mit einem gepulsten Dopplersonographiegerat der FA SMS durchschnittlich 2 Wochen antepartal durchgefuhrt.

Dopplersonographische Blutflußmessung der A. umbilicalis: Ist ein Screening sinnvoll?

Umbilical artery blood flow velocity waveforms during variable decelerations of the fetal heart rate

Blood flow velocities of the umbilical arteries were measured by Doppler ultrasonography during variable decelerations of the fetal heart rate. The flow velocity waveforms, being normal between uterine contractions, showed either an unchanged flow velocity waveform with an exclusive fetal heart rate effect on end-diastolic velocities or a rapid change to absent and reverse diastolic flow during the decelerations, indicating an abrupt increase in placental resistance with a halt in placental perfusion. Computer-aided reconstruction of the fetal heart rate curve revealed the exact temporal relationship between the reduction of umbilical artery perfusion and deceleration of fetal heart rate. W…

Low target birth weight or growth retardation? Umbilical Doppler flow velocity waveforms and histometric analysis of fetoplacental vascular tree

Objective: The placental vascular architecture of small-for-gestatonal-age fetuses seems to have an impact on the flow patterns in the umbilical arteries. Study Design: Blood flow velocity waveforms of the umbilical arteries were measured by Doppler ultrasonography in nine small-for-gestational-age fetuses with elevated systolic/diastolic ratios of the umbilical arteries, seven small-for-gestational-age fetuses with normal flow patterns, and 14 appropriate-for-gestational-age fetuses with normal flow patterns. After delivery histomorphometric placental investigations were performed. Results: Reduced end-diastolic flow velocities were significantly associated with both a reduction of vascula…

Blood flow velocity waveforms of the middle cerebral artery and abnormal neurological evaluations in live-born fetuses with absent or reverse end-diastolic flow velocities of the umbilical arteries.

Abstract We studied 37 fetuses with absent or reverse end-diastolic flow velocities (AREDFV) of the umbilical arteries with respect to the mode of delivery, fetal acidosis, resistance index of the middle cerebral arteries, and abnormal neurological evaluation at the time of discharge from the department of pediatrics. A control group with normal umbilical artery flow velocity waveforms was matched for gestational age. Fetuses with AREDFV were delivered almost exclusively by cesarean section, in most cases due to fetal distress. Metabolic changes with decreased base excess values were found more often in fetuses with AREDFV, but no difference could be detected with respect to severe fetal ac…

CK-BB as indicator of prenatal brain-cell injury in fetuses with absent or reverse end-diastolic flow velocities of the umbilical arteries

The purpose of this study is to determine the levels of brain type isoenzyme of creatine kinase (CK-BB) as a possible indicator of a pre-existing intrauterine brain-cell damage in cord blood sera of fetuses with preceding absent or reverse end-diastolic flow velocities of the umbilical arteries (AREDFV). CK-BB isoenzyme activities were determined in umbilical cord sera of 13 newborn infants with preceding AREDFV and in 14 fetuses with low end-diastolic flow velocities (LEDFV) of the umbilical arteries. 50 newborn infants with elective cesarean section and normal umbilical artery blood flow velocity waveforms were used as controls. Two-tailed Student's t-test and Fischer's exact test were us…