PREDICTIVE VALUE OF DOPPLER UMBILICAL ARTERY VELOCIMETRY IN A LOW-RISK POPULATION WITH NORMAL FETAL BIOMETRY - A PROSPECTIVE-STUDY OF 2016 WOMEN

Objective: To assess the predictive value of Doppler umbilical artery velocimetry in a low-risk population with normal fetal biometry. Study design: Multicenter prospective study in 17 hospitals with prenatal c linics in France. Two thousand sixteen women who, before 28 weeks gest ation were defined as at low risk after routine consultation and after ultrasound. Doppler umbilical artery velocimetry was performed betwee n 28 and 34 weeks gestation. Confounding factors were used to perform multivariate regression. Results: 1903 cases were analysed and 192 (10 .1%) had an abnormal Doppler Resistance Index (RI). The abnormal Doppl er group contained a significantly higher frequency of severe and mode rate small for gestational age infants (SGA), both severe and moderate with a sensitivity of 25.5 and 18.8% respectively. There was no diffe rence in hypertensive disorders or criteria of fetal distress. Mean bi rth weight was very significantly lower in the abnormal group (162 g). Birth weight was very significantly linked to RI after taking into ac count confounding variables in the multiple linear regression model (c ontinuous relationship). After multiple logistic regression,the odds r atio associated with an abnormal Doppler result, adjusted for all the confounding factors, was 2.3 (95% CI 1.5-3.7) for moderate SGA and 3.5 (95% CI of 1.8-7.1) for severe SGA. Conclusion: Low umbilical Doppler RI is predictive with moderate or severe SGA in a low-risk population with normal fetal biometry, even when the information generally avail able in clinical practice and ultrasound parameters are taken into acc ount. There is a continuous relationship between RI and birthweight. T his predictive value cannot, however, lead to an improvement in neonat al health unless effective measures to prevent SGA exist and umbilical Doppler should not be used in low-risk population on a routine basis. Copyright (C) 1997 Elsevier Science Ireland Ltd.