Splenic artery velocity waveforms in small-for-gestational-age fetuses: Relationship with pH and blood gases measured in umbilical blood at cordocentesis - 10/09/11
Abstract |
OBJECTIVE: Our purpose was to relate velocity waveforms from the splenic artery with pH and blood gas levels measured at cordocentesis in small-for-gestational-age fetuses and to compare the diagnostic efficiency of splenic artery waveforms with that of other fetal arterial and venous vessels in predicting acid-base status.
STUDY DESIGN: Cross-sectional recordings from the splenic artery were obtained by color and pulsed Doppler techniques in 316 appropriately grown fetuses, 12 small-for-gestational-age fetuses with normal umbilical artery velocity waveforms (group 1), and 30 small-for-gestational-age fetuses with abnormal umbilical artery velocity waveforms (group 2). Measurements of splenic artery pulsatility index values in small-for-gestational-age fetuses were compared with those of appropriate-for-gestational-age fetuses. Associations of splenic artery pulsatility index with Po2, Pco2, and pH values measured at cordocentesis were examined and compared with those of umbilical artery, middle cerebral artery, and inferior vena cava.
RESULTS: In appropriately grown fetuses pulsatility index values from the splenic artery decrease with advancing gestation (r = 0.51, p < 0.0001). Splenic artery pulsatility index values are lower in group 2 (p < 0.001) but not in group 1 small-for-gestational-age fetuses (p = 0.211). The amplitude of the decrease in the pulsatility index is significantly associated with fetal hypoxemia (r = 0.646, p < 0.001), acidemia (r = 0.593, p < 0.001) and hypercapnia (r = 0.577, p < 0.001). However, logistic regression demonstrates that hypoxia is better predicted by middle cerebral artery pulsatility index, whereas hypercapnia and acidosis are more closely associated with the percent of reverse flow in inferior vena cava.
CONCLUSION: A decrease in the splenic artery pulsatility index occurs in small-for-gestational-age fetuses in the presence of abnormal pH and blood gas values, but a more accurate assessment of acid-base status may be obtained with the study of the middle cerebral artery and inferior vena cava.(Am J Obstet Gynecol 1997;176:300-7.)
Le texte complet de cet article est disponible en PDF.Keywords : splenic circulation, small-for-gestational-age fetuses, growth restriction, Doppler ultrasonography, hypoxemia, acidosis
Plan
 | From the Fetal Medicine Center, Department of Obstetrics and Gynecology, Universita di Roma “Tor Vergata.” |
| Supported by a grant from the Italian National Council of Research (CNR grant No. 95.00895 PF41). A.C. is the recipient of a “Ugo Tropea” Fellowship awarded by the Italian Society of Perinatal Medicine. |
 | Reprint requests: G. Rizzo, MD, Centro di Medicina Fetale, C1. Ostetrica e Ginecologica, Università di Roma “Tor Vergata,” Policlinico Nuovo S. Eugenio, P. le Umanesimo, 10, 00144 Roma, Italy. |
| 6/1/77872 |
Vol 176 - N° 2
P. 300-307 - février 1997 Retour au numéro
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