Identification of fetuses at risk of perinatal mortality by the combination of ductus venosus, myocardial performance index and aortic isthmus Doppler waveforms.
Aim
To evaluate the diagnostic performance of the ductus venosus pulsatility index (DV-PI), modified myocardial performance index (Mod-MPI) and aortic isthmus blood flow velocity index (IFI) in predicting perinatal mortality in intrauterine growth restricted (IUGR) fetuses.
Method
DV-PI, Mod-MPI and IFI were measured in 52 severely affected IUGR fetuses within 48 hours of delivery or fetal death. Perinatal mortality was defined as fetal or early neonatal (<72 hours after birth) death. Individual data were normalised by converting the results in z-scores. ROC and ORs analyses were performed.
Results
Perinatal death occurred in 13 cases (25%). ROC analysis showed: Mod-MPI = 1.6 z-scores (95th percentile) had 84.6% sensitivity (Sen), 68.4% specificity (Spe), 47.2% positive predictive value (PPV), 93% negative predictive value (NPV), 2.68 positive likelihood ratio (LR+), 0.22 LR−; DV-PI = 6.74 z-scores had 46.2% Sen, 97.4% Spe, 85.7% PPV, 84.4% NPV, 18.00 LR+, 0.55 LR−;and IFI = −9.48 z-scores had 58.3% Sen, 80.6% Spe, 50% PPV, 85.3% NPV, 3.0 LR+,0.52 LR−. When 2 out of 3 parameters were altered, the risk of perinatal mortality increased significantly (OR: 6.2; 95% confidence intervals (CI) 1.59–24.18, p = 0.0001). Conversely, none, or only one altered parameter reduced significantly the risk (OR; 0.16; 95%CI 0.04–0.62 p = 0.0001).
Conclusion
Mod-MPI = 1.6 z-scores has the highest sensitivity and negative predictive value. The combination of DV-PI, Mod-MPI and IFI (at least two altered) may be helpful in the identification of IUGR fetuses at risk of mortality.
This information is not meant to replace the advice of any physician or qualified health professional. The information provided by Cerebra is for information purposes only and is not a substitute for medical advice or treatment for any medical condition. You should promptly seek professional medical assistance if you have concerns regarding any health issue.
Page last updated:
16/12/2011 15:43