Ductus venosus Doppler velocimetry in the prediction of acidemia at birth: which is the best parameter?

Abstract

Objectives To evaluate the prediction of acidemia at birth using ductus venosus Doppler velocimetry and to determine the best parameter and cut-off values for this prediction in pregnancies complicated with placental insufficiency.Methods Prospective cross-sectional study. Forty-seven patients with placental insufficiency managed in two Brazilian hospitals were submitted to ductus venosus Doppler velocimetry in the last 24 h before delivery. All pregnancies were singleton, at least 26 weeks of age and without structural or chromosomal anomalies. A ROC curve was calculated for each ductus venosus parameter (independent variable) and acidemia (dependent variable). A cut-off value was established. the McNemar test was used to compare the various parameters.Results the ductus venosus S, D and A peak velocities were not good predictors of acidemia at birth. Pulsatility Index for Veins (PIV) was a good predictor of acidemia (ROC curve area 0.79, p = 0.003), as well as S/A and (S - A)/S ratios (ROC Curve area 0.818, p = 0.001). the cut-off values were PIV = 0.76, S/A = 2.67 and (S - A)/S = 0.63.Conclusions in this high-risk population, angle-independent ductus venosus Doppler indexes were good of birth acidemia. the S/A and (S - A)/S ratios and the ductus venosus PIV were statistically equivalent in this prediction. Copyright (C) 2005 John Wiley & Sons, Ltd.Universidade Federal de São Paulo, Paulista Med Sch, São Paulo Hosp, São Paulo, BrazilCeara Fed Univ, Assis Chateaubriand Teaching Matern, Ceara, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, São Paulo Hosp, São Paulo, BrazilWeb of Scienc