Reference charts for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord
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To determine reference values for umbilical Doppler pulsatility index in fetuses with isolated two-vessel cord and to compare these values with standard umbilical Doppler pulsatility index curves from 23 to 40 gestational weeks.
A retrospective longitudinal cohort study was conducted between January 2014 and December 2017 in a tertiary referral hospital and included 62 pregnant women with isolated single umbilical artery (two-vessel cord) and 174 measurements. Only uncomplicated term pregnancies were included. A reference curve for umbilical Doppler pulsatility index was built up and compared with a standard curve commonly used for fetuses with three-vessel cord.
Umbilical Doppler pulsatility index values were much lower than expected in cases with two-vessel cord compared to 3-vessel cord: mean of the regression equations was 1.02 ± 0.23 vs. 0.86 ± 0.19, respectively (p value < 0.001). This difference was quite constant across the gestational weeks considered, showing that the slopes of the two regressions were very similar.
Reference curves for umbilical Doppler pulsatility index in two-vessel cord pregnancies were determined. Pulsatility index values were significantly different compared with those commonly used for three-vessel cord. Using lower reference values for umbilical pulsatility index in cases with two-vessel cord may allow a better identification of fetuses affected with intrauterine growth restriction, thus improving fetal surveillance.
KeywordsTwo-vessel cord Single umbilical artery Umbilical pulsatility index Reference curve Linear regressions comparison
EC: protocol/project development, data collection, and manuscript writing. IC: data collection. DM: protocol/project development, data collection, and manuscript writing. AF: protocol/project development, data collection, manuscript writing, and data analysis.
The authors received no specific funding for this work.
Compliance with ethical standards
Conflict of interest
We declare that we have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Sant’Orsola Malpighi Hospital Bologna, Italy and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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