Mariusz Z. Skotnicki, Elżbieta Flig, Jan Urban, Tadeusz W. Hermann
Med Sci Monit 2000; 6(3): MT611-615
AIM OF THE STUDY: Determination of correlation between Doppler parametersin the evaluation of fetal state and biochemical and clinical determinants of birth status of the newborn.MATERIAL: 30 full-term pregnancies. METHODS: Doppler parameters were determined in maternal vessels (uterineand arcuate arteries), fetal vessels (middle cerebral arteries, renal artery and descending aorta) andin umbilical arteries and veins. Levels of uric acid, xanthine and hypoxanthine, which reflect oxygendeficiency, were assessed in amniotic fluid by means of HPLC method. Furthermore, clinical conditionof a newborn (rating according to the Apgar scoring system), pH-metry and gasometry in umbilical bloodwere assessed. RESULTS: Significant correlation between determinants of fetal and neonatal conditionand Doppler parameters were determined, that is: between uric acid concentration and blood flow in fetalcerebral arteries, between base excess, pH and blood flow in umbilical vessels, between clinical examinationof birth status of the newborn and renal and arcuate arterial flow and between pO2 and S/D ratio in renalartery. CONCLUSIONS: On the basis of this correlation, the following conclusions were drawn: Dopplerexaminations are highly useful in the prediction of birth status of the newborn if the specific conditionsand appropriate range of the examination are maintained, i.e.: 1) examination must be multivascular,2) it should involve cerebral artery, parenchymal resistance vessels (for example renal artery), umbilicalartery and vein, intramural uterine vessels (for example arcuate or spiral artery), 3) among blood flowparameters not only standard indices (S/D, RI, PI), but also arterial blood flow waves velocity, specificflow and transverse section field should be considered.
Keywords: Acid-Base Equilibrium, Arteries, Blood Gas Analysis, Confidence Intervals, Fetal Blood, Fetus, Gestational Age, Infant, Newborn, Predictive Value of Tests, Pregnancy, Prognosis, Ultrasonography, Doppler, Ultrasonography, Prenatal, Umbilical Arteries, Umbilical Veins, Uterus