Скачать или смотреть Info on fetal growth restriction and umbilical artery dopplers!

Did this happen in your pregnancy?

In fetal growth restriction (FGR), the umbilical artery (UA) end-diastolic flow (EDF) is reduced due to underlying chronic placental insufficiency. The resulting fetal deprivation of nutrients and oxygen is accompanied by sequential fetal compensatory hemodynamic responses, which provide the basis for clinical evaluation and management of FGR.

Elevated S/D: Rising impedance is initially observed in the fetoplacental circulation and is reflected in the falling EDF velocity and the rise of UA Doppler indices.

With continuing deprivation, blood flow is redistributed to favor perfusion of the vital organs, such as the brain, heart, and adrenals, at the expense of flow to muscle, viscera, skin, and other less critical organs. The cerebral redistribution is reflected in a decreased cerebroplacental ratio (CPR), which is the ratio of the middle cerebral artery.

Absent or reversed end diastolic flow or velocity (AEDF/V and REDF/V): With rising fetoplacental circulatory impedance, the EDF may become absent or reversed, which signify worsening fetal status. These changes in EDF occur on average one week before acute deterioration.

Progressive decline of the fetal condition is further manifested by diminished and eventual loss of fetal heart variability and reactivity, and the loss of fetal movement and breathing, indicating impending fetal jeopardy.

There is no evidence for use of umbilical artery dopplers to screen for pregnancy complications, like preeclampsia. There is no evidence to support the use of umbilical artery dopplers in patients with preeclampsia in the absence of FGR.

There is no evidence to support the use of umbilical artery dopplers in diabetic patients in the absence of FGR.

#obgyn #mfm #fetalgrowthrestriction #growthrestriction #fgr #umbilicalcord #umbilicalarterydopplerstudies #umbilicalartery

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I am a double board certified ObGyn and Maternal-Fetal Medicine specialist focusing on the care of people with maternal and/or fetal complications of pregnancy. I discuss hot topics related to fertility, pregnancy and the postpartum period, and do a little myth-busting and fact-checking to keep things real! Not only am I a doc, but I was also a patient who had infertility, a high-risk twin pregnancy and preterm delivery, and NICU stay at age 43 as a first-time mom--so I GET IT! Leave requests for new topics in comments!
 
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