![]() ![]() Pregnant women with multiple pregnancies, fetus with congenital abnormality, and smoking history of mother were not included. Moreover, females with high-risk pregnancy, e.g., with diabetes, cancer, high blood pressure, kidney disease, epilepsy, past history of three or more miscarriages, preterm delivery, preeclampsia or seizures, heart valve problems, asthma, and rheumatoid arthritis, were also included. Eligibility for enrolment was assessed on completion of ultrasound examination.įemales with viable singleton pregnancy with regular antenatal visits and gestational age 28 or more weeks were included. ![]() The hospital serves a population from the middle and lower socioeconomic groups. Power calculation of 80% suggested that a total sample of 100 women in each group was sufficient. All women were recruited by a nonprobability purposive sampling technique from obstetrics unit of Alnoor Specialist Hospital, Makkah, Saudi Arabia, a 550 bedded tertiary care referral center with an average annual delivery rate of 2500. This prospective cohort study was conducted from January 2005 to December 2006. This study was designed to emphasize the effect of Doppler ultrasound on high-risk pregnancies in regard to obstetrical management as well as fetal, prenatal, and neonatal outcome. The hypothesis that Doppler is effective in reducing mortality and major morbidity in high-risk pregnancy could only be tested with a massive randomized trial. Doppler assessment may lead to intervention that reduces the risk of fetal brain damage. On the basis of abnormal Doppler results, obstetrical decision making 3 might improve and prevent intrauterine death because hypoxic cerebral damage may begin before labor 4 and intrapartum asphyxia is probably more damaging when superimposed on underlying hypoxia. It was postulated that Doppler ultrasound would be a useful addition to our catalog of tests of antenatal fetal well-being and timely intervention. Doppler investigation of middle cerebral artery in combination with umbilical artery seems to improve prediction of adverse outcome in near-term pregnancies. The majority of adverse perinatal outcomes in developing countries are placental-associated diseases and it is confirmed that uterine Doppler evaluation predicts most occurrences of early-onset preeclampsia and intrauterine growth restriction, and its use in these pregnancies improves a number of perinatal outcomes. Primarily it appeared that abnormalities in ductus venosus waveform were the endpoint for pregnancies distressed with intrauterine growth restriction contrary to newer data proposing these abnormalities as plateau prior to further fetal deterioration as observed by changes in the biophysical profile. ![]() Recent findings aided in timing delivery of severely growth-restricted fetuses by promoting the use of ductus venosus Doppler. The use of Doppler ultrasound in high risk pregnancies appears to improve a number of obstetric care outcomes and appears promising in helping to reducing perinatal deaths.The significance of Doppler ultrasound in evaluating pregnancies that have the risk for preeclampsia, intrauterine growth restriction, fetal anaemia, and umbilical cord abnormalities has become indispensable. No difference was found for fetal distress in labour (odds ratio 0.81, 95% confidence interval 0.59 to 1.13) or caesarean delivery (odds ratio 0.94, 95% 0.82 to 1.06). The use of Doppler ultrasound was also associated with fewer inductions of labour (odds ratio 0.83, 95% confidence interval 0.74 to 0.93) and fewer admissions to hospital (odds ratio 0.56, 95% 0.43 to 0.72), without reports of adverse effects. Compared to no Doppler ultrasound, Doppler ultrasound in high risk pregnancy (especially those complicated by hypertension or presumed impaired fetal growth) was associated with a trend to a reduction in perinatal deaths (odds ratio 0.71, 95% confidence interval 0.50 to 1.01). The trials were generally of good quality. Study authors were contacted for additional information.Įleven studies involving nearly 7000 women were included. Trial quality was assessed and data were extracted by both reviewers. Randomised trials of Doppler ultrasound for the investigation of umbilical artery waveforms in high risk pregnancies compared to no Doppler ultrasound. We searched the Cochrane Pregnancy and Childbirth Group trials register. The objective of this review was to assess the effects of Doppler ultrasound in high risk pregnancies on obstetric care and fetal outcomes. It is also possible that Doppler ultrasound could encourage inappropriate early delivery. Abnormal waveforms from Doppler ultrasound may indicate poor fetal prognosis. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |