Postnatal systemic blood flow in neonates with abnormal fetal umbilical artery Doppler

Richelle N Olsen; Jennifer Shepherd; Anup Katheria

doi:10.1155/2014/957180

Postnatal systemic blood flow in neonates with abnormal fetal umbilical artery Doppler

ISRN Obstet Gynecol. 2014 Mar 5:2014:957180. doi: 10.1155/2014/957180. eCollection 2014.

Authors

Richelle N Olsen¹, Jennifer Shepherd², Anup Katheria³

Affiliations

¹ Department of Reproductive Medicine, University of California, San Diego, CA, USA.
² Department of Neonatology, University of California, San Diego, CA, USA.
³ Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA 92123, USA.

Abstract

Objective. Abnormal umbilical artery Doppler (UAD) studies are associated with poor neonatal outcomes. We sought to determine if postnatal measures of systemic blood flow (SBF), as measured by functional echocardiography (fECHO), could identify which fetuses with abnormal UAD were at the highest risk of adverse outcomes. Study Design. This is a retrospective review of fetuses with abnormal UAD who received fECHO in the first 72 hours of life. Measures of SBF (right ventricular output (RVO) and superior vena cava (SVC) flow) were performed and compared with prenatal variables and postnatal outcomes. Result. 63 subjects had abnormal UAD, 20 of which also had fECHO. Six subjects had abnormal flow. Gestational age at delivery was similar between the two groups. Those with abnormal SBF had fewer days of abnormal UAD prior to delivery and developed RDS (P < 0.001). Conclusion. Postnatal measures of SBF were associated with poor postnatal outcomes in fetuses with abnormal UAD. Future studies incorporating antenatal measures of SBF may help obstetricians determine which pregnancies complicated by UAD are likely to have postnatal morbidity.