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Journal articles on the topic 'Neonatal umbilical artery'

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Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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1

Merina, Gyawali, and Poudel Ramesh. "Study of abnormal umbilical artery doppler and neonatal outcome." Asian Journal of Medical Sciences 10, no. 5 (August 11, 2019): 98–101. http://dx.doi.org/10.3126/ajms.v10i5.25135.

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Background: Doppler provides assessment of uteroplacental and fetoplacental circulation during pregnancy. It is a sensitive tool in early detection of fetal compromise and allows needful intervention. Aims and Objective: To study the role of umbilical artery doppler in clinically suspected IUGR and its implication on neonatal outcome. Materials and Methods: A total of 104 singleton pregnancies with gestational age of more than 34 weeks who had clinical suspicion of IUGR were evaluated using obstetric ultrasound and doppler. Umbilical arteryvelocimetry with S/D >3 and RI >0.7 were considered abnormal. Newborns were classified as either small for gestational age (SGA) ie, IUGR or appropriate for gestational age (AGA). Neonatal outcome were classified as either normal or adverse events that included still birth, NICU admissions, perinatal asphyxia and/or neonatal death. Results: Out of 104 clinically suspected IUGR, 55 were born with small for gestational age. Among these SGA neonates, 45 subjects had abnormal umbilical artery S/D and 42 had abnormal RI. Abnormal umbilicalartery S/D ratio had a sensitivity of 81.8 %, specificity of 59.2 %, the positive predictive value of 69.2 % and negative predictive value of 74.4 %. Abnormal Umbilical artery RI had a sensitivity of 76.4 %, specificity of 69.4 %, positive predictive value of 73.7 % and negative predictive value of 72.3 % in diagnosing IUGR. Abnormal umbilical artery velocimetry was associated with increased morbidity and mortality in IUGR neonates. Conclusions: Umbilical artery doppler plays an important role in diagnosing IUGR and predicting neonatal outcome.
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2

Patil, Suman Shivanagouda, Sukanya ., Suman Rath, and Carolin Elizabeth George. "Study on umbilical cord arterial blood gas analysis and cord blood lactate levels as predictors for adverse neonatal outcome: an observational study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 4 (March 27, 2018): 1494. http://dx.doi.org/10.18203/2320-1770.ijrcog20181342.

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Background: Perinatal asphyxia is a major cause of neonatal and childhood morbidity and mortality. Electronic foetal monitoring is used routinely to know the condition of the baby during Intrapartum period. Normal trace correlates highly with absence of acidemia at birth. Abnormal trace needs further evaluation. In order to better define the metabolic status of the new born, umbilical lactate levels have been measured. Objectives of this study were to determine the validity of umbilical cord blood lactate levels in predicting the adverse early neonatal outcome in babies with intrapartum foetal distress and to compare the validity of umbilical cord blood lactate and umbilical artery pH in predicting adverse neonatal outcome in babies with intrapartum foetal distress.Methods: 295 pregnant women with abnormal CTG in active labour were subjected for estimation of cord blood lactate and umbilical artery pH immediately after delivery and were compared in predicting adverse neonatal outcome.Results: In the present study specificity of serum lactate (97.7%) and umbilical artery pH (95.97%) was almost similar in babies with Apgar <7 at 1 minute and 5 minutes, but sensitivity of serum lactate (23.14%) and cord ph (31.4%) was less in babies with Apgar score ≤7 at 1 minute. Area under ROC showed serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH.Conclusions: Umbilical cord blood lactate is more specific than umbilical artery pH in predicting adverse neonatal outcome. Area under ROC (at 95th percentile) shown serum lactate is more accurate in predicting adverse neonatal outcome compared to umbilical artery pH at birth.
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3

Choudhary, Neelima, Ashima Kesri, Shilpi Nain, Vikas Chaudhary, and S. S. Trivedi. "Effects of antenatal corticosteroids administration on fetoplacental circulation in preterm pregnancies with intrauterine growth restriction and its correlation with perinatal outcome." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 6 (May 27, 2020): 2566. http://dx.doi.org/10.18203/2320-1770.ijrcog20202349.

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Background: Antenatal corticosteroid administration in preterm pregnancies is recommended to promote fetal lung maturation. Studies have reported temporary reduction in fetal heart rate, breathing and movements following maternal corticosteroid administration. Authors studied effect of maternal corticosteroid administration on fetoplacental circulation in preterm pregnancies with IUGR and its correlation with perinatal outcome.Methods: Observational study included 77 preterm singleton pregnant women with IUGR. Color doppler day 0 (before betamethasone) of umbilical artery of 77 cases done. All received two doses of 12 mg of betamethasone intramuscularly 24 hours apart. Umbilical artery doppler on day 2 (24 to 48 hours of 1st dose of betamethasone) and day 4 (72 to 96 hours of 1st dose of betamethasone) done. Pulsatility index (PI) of umbilical artery on doppler and Neonatal details of all women noted.Results: On day 2 doppler, 56 (73%) women (Group A) showed decrease in umbilical artery PI while 21 (27%) women (Group B) did not show decrease in umbilical artery PI. Mean umbilical artery PI of 77 cases on day 0 and day 2 were 1.73±0.73 and 1.54±0.76 respectively (p<0.001). Mean Umbilical artery PI values of undelivered 60 cases on day 0, day 2 and day 4 were 1.55±0.61, 1.33±0.55 and 1.47±0.63 respectively (p<0.001). Group B neonates had poorer Apgar scores, higher neonatal complication, longer hospital stay, lesser umbilical pH at birth and higher perinatal mortality rate than Group A neonates.Conclusions: Significant reduction in mean umbilical artery PI observed on day 2 following betamethasone administration (p<0.001), which was maintained till 4th day after 1st dose of betamethasone (p<0.05). Women who showed improvement in umbilical artery pulsatility index following betamethasone administration had a better perinatal outcome as compared to women who did not.
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4

Majid Salman, Ahmed, Mohammed A.K. Al-Jiboori, Hadeel Qasim Khaleel, and Enas Adnan. "The Role of The Doppler Study (Umbilical, Middle, Cerebral Arteries and Ductus Venosus) to Predict General Adverse Pregnancy Outcomes in Patients With Hypertensive Diseases in The Third Trimester." Diyala Journal of Medicine 21, no. 2 (December 25, 2021): 10–21. http://dx.doi.org/10.26505/djm.21025751023.

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Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes. Keywords: Hypertensive disorder, Middle cerebral artery, Umbilical artery, Ductus venosus
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5

Pari, Priyatharsini, Bharathi U, Pradha Velu, and Sowndaravel S. "The missing umbilical artery – A case report." IP Journal of Diagnostic Pathology and Oncology 6, no. 4 (November 15, 2021): 322–24. http://dx.doi.org/10.18231/j.jdpo.2021.069.

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Single umbilical artery (SUA) is a condition where one umbilical artery exists. Normally, the umbilical artery contains two umbilical artery and one umbilical vein. The incidence of SUA varies from 0.2% to 0.8%. We present a case of SUA in a term baby with birth weight of 1.7kg delivered by a 28-year-old mother. SUA is a condition which must be kept in mind during histopathological examination since it helps in improving the neonatal and maternal care.
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6

L., Rashmi, and Ashish Bhattacharjee. "Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 2 (January 23, 2018): 628. http://dx.doi.org/10.18203/2320-1770.ijrcog20180184.

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Background: Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy. The aim of this study was to study the umbilical artery Doppler velocimetry in predicting the fetal outcome in high risk pregnancy. This is a prospective study done over a period of 1 year in Silchar Medical College and Hospital from 1st September 2011 to 31st August 2012. 100 women with singleton pregnancy with high risk admitted in SMCH were subjected to umbilical artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria.Methods: 100 women with high risk pregnancy were evaluated by umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n = 79; 79%), the low-end diastolic flow group (n = 19; 19%) and the group with absent/reversed diastolic flow (n = 2; 2%).Results: Mothers with abnormal velocimetry had more number of caesarean sections than those with normal velocimetry. The diagnosis to delivery interval, gestational age at delivery and average birth weight were comparatively lower with higher incidence of admission to neonatal intensive care unit in foetuses with abnormal umbilical Doppler velocimetry. Sensitivity, specificity, positive and negative predictive values of Doppler for detecting abnormal fetal outcome were 43%, 83%, 33% and 88% respectively. Statistical analysis used: sensitivity, specificity and predictive values.Conclusions: Fetuses with normal flow velocimetry are at lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower than that of neonates with normal velocimetry. Doppler velocimetry studies of umbilical artery can provide the obstetrician important information regarding fetal wellbeing to help him improve fetal outcome.
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7

Contag, Stephen, Silvia Visentin, Katherine Goetzinger, and Erich Cosmi. "Use of the Renal Artery Doppler to Identify Small for Gestational Age Fetuses at Risk for Adverse Neonatal Outcomes." Journal of Clinical Medicine 10, no. 9 (April 23, 2021): 1835. http://dx.doi.org/10.3390/jcm10091835.

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Objective: To measure the sensitivity and positive predictive value (PPV) for an adverse neonatal outcome among growth-restricted fetuses (FGR) comparing the cerebral–placental ratio (CPR) with the cerebral–renal ratio (CRR). Methods: Retrospective analysis of 92 women who underwent prenatal ultrasound at the University of Maryland and the University of Padua. Renal, middle cerebral and umbilical artery Doppler waveforms were recorded for all scans during the third trimester. The last scan prior to delivery was included for analysis. We calculated the test characteristics of the pulsatility indices (PI) of the umbilical and renal arteries in addition to the derived CPR and CRR to detect a composite adverse neonatal outcome. Results: The test characteristics of the four Doppler ratios to detect increased risk for the composite neonatal outcome demonstrated that the umbilical artery pulsatility index had the best test performance (sensitivity 64% (95% CI: 47–82%), PPV 24% (95% CI: 21–27), and positive likelihood ratio 2.7 (95% CI: 1.4–5.2)). There was no benefit to using the CRR compared with the CPR. The agreement between tests was moderate to poor (Kappa value CPR compared with CRR: 0.5 (95%CI 0.4–0.70), renal artery PI:−0.1 (95% CI −0.2–0.0), umbilical artery PI: 0.5 (95% CI 0.4–0.7)). Only the umbilical artery had an area under the receiver operating curve that was significantly better compared with the CPR as a reference (p-value < 0.01). Conclusions: The data that we present do not support the use of renal artery Doppler as a useful clinical test to identify a fetus at risk for an adverse neonatal outcome. Within the various indices applied to this population, umbilical artery Doppler performed the best in identifying the fetuses at risk for an adverse perinatal outcome.
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8

Birs, Antoinette S., Jose A. Perez, Mark A. Rich, and Hubert S. Swana. "Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate." Case Reports in Urology 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/1425373.

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Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates.
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9

Weisz, Boaz, Liat Hogen, Yoav Yinon, Liat Gindes, Alon Shrim, Michal Simchen, Eyal Schiff, and Shlomo Lipitz. "Perinatal Outcome of Monochorionic Twins With Selective IUGR Compared With Uncomplicated Monochorionic Twins." Twin Research and Human Genetics 14, no. 5 (October 1, 2011): 457–62. http://dx.doi.org/10.1375/twin.14.5.457.

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Objective: To evaluate the perinatal outcome of MC twins with selective IUGR (sIUGR).Study design: A prospective study, which included three groups of MC twins: Group A, uncomplicated MC twin pregnancies (n = 91); group B, sIUGR with normal umbilical artery Doppler (n = 19); and group C, sIUGR with abnormal (absence or reversed EDV) umbilical artery Doppler (n = 18). The latter were routinely hospitalized in the high-risk ward under strict surveillance.Results: Neonatal outcome of fetuses complicated with sIUGR and normal Doppler was similar to controls. Neonates born to pregnancies complicated by sIUGR and abnormal Doppler had significantly increased incidence of CNS findings, RDS, NEC, sepsis, and neonatal death compared to controls. Adverse outcome in this group was independently associated only with gestational age at birth.Conclusion: The perinatal outcomes of MC twins complicated with sIUGR and normal Doppler are similar to uncomplicated MC pregnancies. MC twins with sIUGR and abnormal Doppler have reasonable outcomes, yet significantly more neonatal complications compared to non-complicated MC twins.
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10

Katz, ME, JM Perlman, ED Tack, and WH McAlister. "Neonatal umbilical artery pseudoaneurysm: sonographic evaluation (case report)." American Journal of Roentgenology 147, no. 2 (August 1986): 322–24. http://dx.doi.org/10.2214/ajr.147.2.322.

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11

Urbach, Joseph, Michael Kaplan, Orna Blondheim, and Harry J. Hirsch. "Neonatal hypoglycemia related to umbilical artery catheter malposition." Journal of Pediatrics 106, no. 5 (May 1985): 825–26. http://dx.doi.org/10.1016/s0022-3476(85)80367-x.

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12

Taghavi, Simin, Tahereh Alizadeh Ghaleh Lar, Fatemeh Abasalizadeh, Maryamalsadaten Kazemi Shishava, Shamsi Abasalizadeh, Sanaz Moosavi, Zahra Fardi Azar, and Mojgan Mirghafourvand. "Changes in Umbilical Artery Doppler Velocimetry After Betamethasone Administration in Pregnancies With Fetal Growth Retardation." International Journal of Women's Health and Reproduction Sciences 8, no. 3 (June 14, 2020): 311–18. http://dx.doi.org/10.15296/ijwhr.2020.50.

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Objectives: The administration of betamethasone is associated with increased placental vascular resistance results in the return of the diastolic flow. This study aimed to assess the changes in the flow velocity waveform (FVW) color Doppler in the umbilical artery after the administration of betamethasone in pregnancies with fetal growth retardation (FGR). Materials and Methods: This descriptive-analytical research included all pregnant women who were referred to Al-Zahra teaching hospital and diagnosed with FGR. The eligibility criteria were the impaired umbilical artery FVW color Doppler, qualified for the administration of a fix-dosed Betamethasone, and no fetal abnormalities. The perinatologists performed the FVW color Doppler ultrasonography before and after the administration of betamethasone at intervals of 24, 48, and 96 hours and weeks 1 and 2. FVWs were obtained by pulsed-wave Doppler ultrasonography. Then, neonatal outcomes were recorded based on neonates’ admission documents. Finally, one-way repeated measures ANOVA, Cochran’s Q test, and paired-samples t-test were used to compare Doppler indices before and after betamethasone administration. Results: The mean pulsatility index (PI) and resistance index (RI) of the umbilical artery showed a statistically significant reduction after the administration of betamethasone (P<0.001). The measured umbilical artery PI at two weeks after drug administration predicted the neonatal intensive care unit admission (P = 0.042). Eventually, the results revealed no significant association between the amniotic fluid index (AFI) and betamethasone administration (P = 0.3). Conclusions: In general, betamethasone administration improved the FVWs of the umbilical artery in pregnant women with fetal growth restriction while no association was found between the AFI and betamethasone administration.
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13

R., Rajarajeswari, and V. Thendral. "Prediction of perinatal outcome with umbilical artery Doppler in IUGR fetuses- a prospective analytical study in a tertiary medical college in Tamilnadu, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 3 (February 19, 2017): 1097. http://dx.doi.org/10.18203/2320-1770.ijrcog20170592.

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Background: Umbilical artery Doppler blood flow studies were a better predictor of neonatal outcome than estimated fetal weight alone in intrauterine growth restricted (IUGR) fetuses. Perinatal mortality and morbidity are increased if the umbilical artery Doppler abnormality worsens.Methods: This study was conducted in Department of Obstetrics and Gynaecology, Thanjavur medical college from August 2015 to August 2016. One hundred singleton pregnancies complicated by IUGR beyond 32 weeks were subjected for Doppler study of umbilical artery. Perinatal outcome in terms of baby outcome, birth weight, early neonatal death, admission in NICU and duration of admission in NICU were analysed.Results: The main indication of termination of pregnancy was oligohydramnios (70%). The other causes of termination were 8% for uncontrolled hypertension and 4 % for post term. 60 % were delivered vaginally and 40% by lower segment cesarean section. Various indication for LSCS were Non-reactive CTG, fetal distress, severe oligohydramnios and failed induction. 92% were delivered alive babies and 8% still born babies. Birth weight of the babies varied from 900gm to 2.5Kg. But patients with absent or reversed end diastolic flow in umbilical artery Doppler, 80% of the babies weighed less than 1.5Kg. Perinatal mortality in our study is 19% which includes 8% of intrapartum mortality and 11% of neonatal mortality and perinatal morbidity is 24%. When the diastolic flow in the umbilical artery is, absent or reversed, it is associated with increased perinatal mortality of 80%.Conclusions: The results of present study clearly demonstrated the efficacy of umbilical artery Doppler in predicting the fetal outcome. To improve the predictive value of this tool, a better method is needed to assess the wellbeing of the IUGR fetuses such as integrated antenatal test which combines BPP and Doppler study employing other vessels.
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14

Kannan, Mohanraj, Aishwarya Lakshmi L. G., Rajakumar P. G., and Selvaraj R. "Early neonatal outcome of preterm babies with absent or reverse end diastolic flow in antenatal doppler velocimetry." International Journal of Contemporary Pediatrics 8, no. 9 (August 23, 2021): 1462. http://dx.doi.org/10.18203/2349-3291.ijcp20213224.

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Background: Preterm babies with abnormal doppler velocimetry during second and third trimesters of pregnancy pose various early neonatal morbidities like recurrent hypoglycaemia, feed intolerance and prolonged hospital stay. In our study we compared the incidence of hypoglycaemia, feed intolerance, risk of necrotising enterocolitis (NEC) and length of hospital stay among preterm babies with abnormal doppler flow to the gestational age matched preterm babies with normal umbilical artery doppler flow velocimetry.Methods: 30 preterm babies who had abnormal umbilical artery flow during their last antenatal doppler scan were included as study group and gestational age matched 30 preterm babies who had normal doppler study had been taken as controls. The incidence of hypoglycaemia, feed intolerance, NEC, length of hospital stay had been compared between two groups.Results: The case group with abnormal umbilical artery doppler had increased incidence of hypoglycaemia (15 of 30 babies in case versus 5 of 30 babies in control) which was statistically significant. Feed intolerance, necrotizing enterocolitis and length of hospital stay were all significantly increased in preterm babies with abnormal umbilical artery doppler when compared to preterm babies with normal umbilical artery doppler flow.Conclusions: Preterm babies with abnormal umbilical artery doppler were at increased risk of hypoglycaemia, feed intolerance, NEC and prolonged hospital stay. Knowledge on this is important to monitor closely for hypoglycaemia, gradually increase feeds and explain parents about expected morbidities which can increase the length of hospital stay in neonatal intensive care unit (NICU).
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15

Pugalia, Saloni, Sabrina Mhapankar, Shruthi Shetty, and Sushil Kumar. "Correlation Between Fetal Middle Cerebral Artery and Umbilical Artery Doppler Ratio at 38-40 weeks of Gestation with Fetal Distress and Adverse Perinatal Outcome." GLOBAL JOURNAL OF MEDICAL STUDENTS 02, no. 02 (2022): 21–26. http://dx.doi.org/10.52314/gjms.2022.v2i2.72.

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Background and Objectives: The study aimed to determine the correlation between fetal middle cerebral artery and umbilical artery doppler ratio with fetal distress at 38-40weeks of gestation. Materials and Methods: In this prospective observational study, 100 pregnant patients between 38-40 weeks of gestational age with no complications were selected from April 2020 to October 2021.They were subjected to Doppler ultrasonography and all the indices such as Middle cerebral artery, Umbilical artery, and Cerebroplacental (C/U) ratio were noted. The patients were followed till delivery and monitored for maternal, fetal, and neonatal outcomes. Results: The mean cerebroplacental ratio was 1.33. there was a significant association between the low C/U ratio with caesarean section and poor perinatal outcome in terms of APGAR <7 at 5minutes, meconium liquor, respiratory distress syndrome, neonatal death, and NICU admission. There was a significant association of low middle cerebral artery PI (p=0.0004), high umbilical artery PI (P=<0.0001), and low C/U ratio (p=<0.0001) with fetal distress. The C/U ratio cut-off ≤1.33 led to sensitivity, specificity, PPV, and NPV of 82.86, 78.46, 67.4, and 89.5%, respectively. There was a linear relationship between birth weight (p=0.10) and postdelivery cord pH(<0.0001) with a C/U ratio. Hence, although sensitivity of cerebroplacental ratio and umbilical artery PI are comparable, the specificity of cerebro-placental ratio is higher than that of umbilical artery PI. Conclusion: It may be concluded that the Cerebroplacental ratio is a better predictor of fetal distress and adverse perinatal outcome than the individual pulsatility index of middle cerebral artery and umbilical artery taken alone.
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Şenyuva, İrem, and Şirin Küçük. "Discordant umbilical arteries in the umbilical cord entanglement: a light microscope study." Perinatal Journal 29, no. 3 (December 3, 2021): 231–37. http://dx.doi.org/10.2399/prn.21.0293009.

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Objective The present study aimed to examine the histopathological diagnosis of the umbilical artery discordance in cases with single or multiple umbilical cord entanglement and pregnancy outcomes. Methods The vascular structure of the umbilical cord, histopathological findings of the placenta and obstetric outcomes were retrospectively examined in 50 cases. The cases were divided into two groups by the number of cord entanglement (single-multiple) and their histopathological findings and neonatal Apgar scores were assessed. Results Out of 50 cases, 38 (76%) had single and 12 (24%) had multiple cord entanglement. In 50 cases, the mean gestational age was 39.16±1.06 weeks, neonatal Apgar scores were 8.7±0.58 at 1 minute and 9.64±0.56 at 5 minute. No statistically significant difference was detected between single and multiple groups in terms of gestational age (p=0.79), 1-minute Apgar score (p=0.832) and 5-minute Apgar score (p=0.656). In histopathological examination, the diameters of umbilical arteries 1 and 2 were found to be 0.11±0.12, 0.09±0.05 µm, respectively in the single group (p=0.756) and 0.13±0.14, 0.06±0.02 µm, respectively in the multiple group (p=0.131). When the umbilical arterial diameters were compared by group, the diameter of the umbilical artery 2 was detected 0.09±0.05 µm in the single and 0.06±0.02 µm in the multiple group and statistically significant difference was detected (p=0.037). Out of 50 cases, placental hypoxia finding was detected as chorangiosis only in 10 cases (2 multiple, 8 single). Conclusion Umbilical artery discordance was detected in cases with multiple umbilical cord entanglement. However, poor pregnancy outcome was not observed in any of the cases. When multiple cord entanglement is seen during obstetric examination, umbilical artery discordance must be remembered and investigated, and also maternal-fetal condition should be considered.
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Seibert, JJ, BJ Taylor, SL Williamson, BJ Williams, JS Szabo, and SL Corbitt. "Sonographic detection of neonatal umbilical-artery thrombosis: clinical correlation." American Journal of Roentgenology 148, no. 5 (May 1987): 965–68. http://dx.doi.org/10.2214/ajr.148.5.965.

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18

Diamond, David A., and Carla Ford. "Neonatal Bladder Rupture: A Complication of Umbilical Artery Catheterization." Journal of Urology 142, no. 6 (December 1989): 1543–44. http://dx.doi.org/10.1016/s0022-5347(17)39157-7.

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19

TRUDINGER, B. J., C. M. COOK, W. B. GILES, S. NG, E. FONG, A. CONNELLY, and W. WILCOX. "Fetal umbilical artery velocity waveforms and subsequent neonatal outcome." BJOG: An International Journal of Obstetrics and Gynaecology 98, no. 4 (April 1991): 378–84. http://dx.doi.org/10.1111/j.1471-0528.1991.tb13428.x.

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20

Wade, Mouhamadou, Mamour Gueye, Aissatou Mbodji, and Mame D. Ndiaye. "Absence of Wharton's jelly around an umbilical artery." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 1 (December 28, 2021): 259. http://dx.doi.org/10.18203/2320-1770.ijrcog20215115.

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Wharton's jelly is a mucoid, avascular and connective tissue which plays the role of umbilical vessels protection. Its absence exposes to poor neonatal outcomes or fetal death. We report a rare case of Absence of Wharton’s Jelly, diagnosed by examination of the placenta the examination with a live fetus.
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Mulcaire-Jones, John P., David K. Bailly, Deborah U. Frank, Anupam R. Verma, Bradley J. Barney, and Heather M. Siefkes. "Spontaneous aortic thrombosis in neonates: a case report and review of literature." Cardiology in the Young 30, no. 1 (January 2020): 95–99. http://dx.doi.org/10.1017/s1047951119003093.

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AbstractNeonatal aortic thrombosis is a rare occurrence but can be life-threatening. Most aortic thrombosis in neonates is related to umbilical artery catheters. A case of a neonate with a spontaneous aortic thrombosis is described here along with a comprehensive review of the literature for cases of neonatal aortic thrombosis not related to any intravascular device or procedure. The aetiologies of these spontaneous thromboses and the relevance of hypercoagulable disorders are discussed. The cases were analysed for odds of death by treatment method adjusted for era. The reference treatment method was thrombolysis and anticoagulation. No other treatment modality had significantly lower odds than the reference. Surgery alone had higher odds for death than the reference, but this may be confounded by severity of case. The management recommendations for clinicians encountering neonates with spontaneous neonatal aortic thrombosis are discussed.
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Mammen, Kitty Elizabeth. "Role of Umbilical and Middle Cerebral Artery Doppler in Predicting Perinatal Outcome in Cases of Preeclampsia." Journal of Evidence Based Medicine and Healthcare 8, no. 04 (January 25, 2021): 195–98. http://dx.doi.org/10.18410/jebmh/2021/37.

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BACKGROUND One of the most common complications of pregnancy is preeclampsia, characterized by abnormal placental development, leading to inadequate uteroplacental blood flow. Doppler ultrasonography can pick up these abnormalities; thus, it is a useful tool to assess fetal outcome. Objective is to calculate the role of colour Doppler (umbilical and middle cerebral artery) in predicting the perinatal outcome. We wanted to evaluate the application of Doppler ultrasound in analysing the blood flow velocity waveform. METHODS This was a cross sectional study carried out between May 2010 - November 2012 in Obstetrics Department, Yenepoya Medical College, Karnataka, among 150 pregnant women with preeclampsia. RESULTS 49.3 % of patients belonged to 25 - 30 years, 58.7 % were primigravida, and 73.3 % and 26.7 % had mild and severe preeclampsia respectively. Patients with increased resistance umbilical artery Doppler - 63.8 % had babies < 2.5 Kg birth weight, 60.9 % Apgar < 7 at 5 minutes of birth and 67.5 % neonatal intensive care unit (NICU) admissions; absent end diastolic flow - all had birth weight < 2 Kg, 90 % Apgar < 7 at 5 minutes, 1 neonatal death and all required NICU admissions; reversal end diastolic flow - 1 neonatal death, all had birth weight < 2.5 Kg, an Apgar < 7 at 5 minutes and required NICU admission. Patients with abnormal Doppler in middle cerebral artery, 46.2 % were low birth weight and had Apgar < 7 at 5 minutes, 50 % required NICU admissions, but no perinatal mortality. CONCLUSIONS Doppler analysis helps in early detection of uteroplacental and fetoplacental changes and to take decisions for early interventions, like administration of steroids for fetal lung maturity and transferring preterm pregnancies to higher centres for better NICU facilities. Umbilical artery Doppler findings are slightly better predictors of adverse perinatal outcome than an abnormal middle cerebral artery. KEYWORDS Doppler, Preeclampsia, Perinatal Outcome, Umbilical Artery, Middle Cerebral Artery
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Katsura, Daisuke, Suzuko Moritani, Shunichiro Tsuji, Kaori Hayashi, Kazutaka Yamada, Shinsuke Tokoro, Kounosuke Suzuki, Fuminori Kimura, and Takashi Murakami. "Prenatal Diagnosis of Umbilical Cord Ulcer: A Report of Two Cases." Case Reports in Obstetrics and Gynecology 2019 (December 20, 2019): 1–5. http://dx.doi.org/10.1155/2019/3768761.

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Umbilical cord ulcer is related to fetal intestinal atresia or meconium; perforation of the ulcer causes fetal deterioration leading to fetal and neonatal death owing to fetal hemorrhage. However, to the best of our knowledge, a method to diagnose umbilical cord ulcer prenatally is not available. No reports exist about the prenatal findings before perforation of umbilical cord ulcer using ultrasonography. We encountered two cases of umbilical cord ulcer showing ultrasonographic finding of a linear echo around the umbilical cord. Umbilical cord ulcers with an exposed umbilical cord artery in the first case and with perforation of the artery in the second case were diagnosed postnatally. When we encounter such ultrasonographic finding, especially with polyhydramnios and high amniotic bile acid concentration in cases of fetal intestinal atresia, risk of perforation of the umbilical cord ulcer should be included in the differential diagnosis.
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Kuper, Spencer, Michelle Wang, Robin Steele, Joseph Biggio, Lorie Harper, and Sima Baalbaki. "Impact of Intended Mode of Delivery on Outcomes in Preterm Growth-Restricted Fetuses." American Journal of Perinatology 35, no. 07 (November 28, 2017): 605–10. http://dx.doi.org/10.1055/s-0037-1608812.

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Background Scheduled cesarean is frequently performed for fetal growth restriction due to concerns for fetal intolerance of labor. Objective We compared neonatal outcomes in preterm growth-restricted fetuses by intended mode of delivery. Study Design We performed a retrospective cohort study of indicated preterm births with prenatally diagnosed growth restriction from 2011 to 2014 at a single institution. Patients were classified by intended mode of delivery. The primary outcome was a composite of adverse neonatal outcomes, including perinatal death, cord blood acidemia, chest compressions during neonatal resuscitation, seizures, culture-proven sepsis, necrotizing enterocolitis, and grade III–IV intraventricular hemorrhage. Secondary analysis was performed examining the impact of umbilical artery Dopplers. Results Of 101 fetuses with growth restriction, 75 underwent planned cesarean deliveries. Of those induced, 46.2% delivered vaginally. Delivery by scheduled cesarean was not associated with a decreased risk of the composite outcome (adjusted odds ratio [aOR], 1.61; 95% confidence interval [CI], 0.45–5.78), even when only those with abnormal umbilical artery Dopplers were considered (aOR, 2.8; 95% CI, 0.40–20.2). Conclusion In this cohort, planned cesarean was not associated with a reduction in neonatal morbidity, even when considering only those with abnormal umbilical artery Dopplers. In otherwise appropriate candidates for vaginal delivery, fetal growth restriction should not be considered a contraindication to trial of labor.
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Gallotti, Roberto, Cheryl E. Cammock, Natalia Dixon, and Yoshio Ootaki. "Neonatal ascending aortic thrombus: successful medical treatment." Cardiology in the Young 23, no. 4 (October 3, 2012): 610–12. http://dx.doi.org/10.1017/s1047951112001394.

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AbstractNeonatal aortic thrombosis is a potentially life-threatening condition with significant morbidity and mortality if undiagnosed and untreated. The most common location of arterial thrombosis in neonates is in the abdominal aorta and is associated with umbilical artery catheterisation. There are only a few previous reports of thrombosis in the ascending aorta. We describe a case of ascending aortic thrombosis in a neonate who underwent successful thrombolytic therapy.
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Singhania, Shraddha, Akhita Singhania, and Saherish Khan. "Study of the Significance of Fetal Doppler Flow Velocimetry in the Perinatal Outcome of Growth-restricted Fetuses." International Journal of Infertility & Fetal Medicine 8, no. 2 (August 2017): 83–88. http://dx.doi.org/10.5005/jp-journals-10016-1153.

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ABSTRACT Purpose To evaluate clinically suspected cases of intrauterine growth restriction (IUGR) for Doppler study of uterine artery, umbilical artery, and fetal middle cerebral artery. To compare the various indices of the three vessels in predicting perinatal outcome. To evaluate the positive predictive value among these parameters. To compare the Doppler findings with fetal outcome. Materials and methods One hundred and two singleton pregnancies complicated by IUGR and severe preeclampsia or both were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery, and umbilical vein which were compared with 104 uncomplicated pregnancies that formed the control group. Observation and Results One hundred and two singleton pregnancies included in the study population had at least one major or minor adverse outcome. Major adverse outcome criteria included perinatal deaths — including intrauterine and early neonatal deaths, etc. Minor outcomes included cesarean delivery for fetal distress, APGAR score below 7 at 5 minutes, and admission to neonatal intensive care unit for treatment. Conclusion Low diastolic and high indices characterize the pregnancies with abnormal outcomes. The uterine artery had a better sensitivity and specificity as compared with the umbilical arteries and diastolic notch had the highest sensitivity and specificity. Doppler also provides a noninvasive method of assessing the fetal and maternal circulation during pregnancy. How to cite this article Kumar V, Sharma G, Khan S, Singhania A, Singhania S. Study of the Significance of Fetal Doppler Flow Velocimetry in the Perinatal Outcome of Growth-restricted Fetuses. Int J Infertil Fetal Med 2017;8(2):83-88.
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B., Shivaprasad, and Devendrakumar Sharma. "To compare the perinatal outcome of IUGR infants with abnormal and normal antenatal umbilical artery Doppler flow in the immediate neonatal period." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 4 (March 30, 2017): 1449. http://dx.doi.org/10.18203/2320-1770.ijrcog20171408.

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Background: Intrauterine growth restriction (IUGR) is one of the cause of perinatal mortality and morbidity and affects approximately 7-15% of worldwide pregnancies. IUGR is the failure of the fetus to achieve intrinsic growth potential, due to disorders and diseases in the feto–placental–maternal unit. Doppler indices from the fetal circulation can reliably predict adverse perinatal outcome. Aim of the study was to determine perinatal outcome of IUGR infants with abnormal antenatal umbilical artery Doppler flow versus IUGR infants with normal Doppler flow.Methods: All Preterm and term IUGR infants with abnormal and normal antenatal umbilical artery Doppler scan admitted in NICU of St Martha’s Hospital were included in the study. 30 in each group with total sample size of 60. Study was conducted from March 2015 to February 2016. Primary outcome measure will be neonatal mortality and secondary outcome measure will be neonatal morbidities like perinatal asphyxia, hypoglycemia, NEC, polycythemia, sepsis, hyperbilirubinemia etc.Results: IUGR infants with abnormal antenatal umbilical artery Doppler scan were included as cases and those with normal antenatal umbilical artery Doppler scan as control. At birth resuscitation rate and therefore perinatal asphyxia was observed more in case group, 11 out of 30 (36.6%), compared to 1 out of 30 (3.3%) in control group, statistically significant (P <0.05). Hypoglycemia was noticed in 19 infants in case group (63.3%) compared to 2 infants (6.6%) in control group, statistically significant. NEC, polycythemia, sepsis was noticed more in case group, but statistically not significant.Conclusions: Infants with abnormal antenatal Doppler flow are at increased risk of perinatal complications than infants with normal antenatal umbilical artery Doppler and needs extra care during this period.
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Afroze, Zakia, and Rokeya Begum. "Significance of Umbilical Artery Velocimetry in Perinatal Outcome of Growth Restricted Fetuses." Journal of Bangladesh College of Physicians and Surgeons 33, no. 1 (June 5, 2016): 12–17. http://dx.doi.org/10.3329/jbcps.v33i1.27994.

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Objectives: To study pregnancy outcomes in growth restricted fetuses with normal umbilical artery velocimetry, low end-diastolic umbilical flow, and absent or reversed diastolic flow. Methods: Fifty pregnant women with growth restricted fetuses were evaluated by umbilical artery velocimetry between 28 and 39 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n=17; 34%), the low end diastolic flow group (n=23; 46%), the group with absent diastolic flow (n=8; 16%) and the group with reversed diastolic flow (n=2; 4%). Results: The average birth weight, diagnosis to delivery interval and gestational age at delivery were comparatively lower in case of abnormal umbilical Doppler velocimetry group. Again there was higher incidence of LSCS for fetal distress, Apgar score <7 at 1 minute, admission to neonatal intensive care unit and perinatal death with those of the abnormal umbilical Doppler velocimetry. Conclusion: Doppler study of umbilical artery allows a noninvasive assessment of uteroplacental insufficiency and is an accurate method for diagnosis and management of fetal growth retardation.J Bangladesh Coll Phys Surg 2015; 33(1): 12-17
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Espada-Trespalacios, Xavier, Felipe Ojeda, Mercedes Perez-Botella, Raimon Milà Villarroel, Montserrat Bach Martinez, Helena Figuls Soler, Israel Anquela Sanz, Pablo Rodríguez Coll, and Ramon Escuriet. "Oxytocin Administration in Low-Risk Women, a Retrospective Analysis of Birth and Neonatal Outcomes." International Journal of Environmental Research and Public Health 18, no. 8 (April 20, 2021): 4375. http://dx.doi.org/10.3390/ijerph18084375.

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Background: In recent years, higher than the recommended rate of oxytocin use has been observed among low-risk women. This study examines the relationship between oxytocin administration and birth outcomes in women and neonates. Methods: A retrospective analysis of birth and neonatal outcomes for women who received oxytocin versus those who did not. The sample included 322 women with a low-risk pregnancy. Results: Oxytocin administration was associated with cesarean section (aOR 4.81, 95% CI: 1.80–12.81), instrumental birth (aOR 3.34, 95% CI: 1.45–7.67), episiotomy (aOR 3.79, 95% CI: 2.20–6.52) and length of the second stage (aOR 00:18, 95% CI: 00:04–00:31). In neonatal outcomes, oxytocin in labor was associated with umbilical artery pH ≤ 7.20 (OR 3.29, 95% CI: 1.33–8.14). Admission to neonatal intensive care unit (OR 0.56, 95% CI: 0.22–1.42), neonatal resuscitation (OR 1.04, 95% CI: 0.22–1.42), and Apgar score <7 (OR 0.48, 95% CI: 0.17–1.33) were not associated with oxytocin administration during labor. Conclusions: Oxytocin administration during labor for low-risk women may lead to worse birth outcomes with an increased risk of instrumental birth and cesarean, episiotomy and the use of epidural analgesia for pain relief. Neonatal results may be also worse with an increased proportion of neonates displaying an umbilical arterial pH ≤ 7.20.
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Abdelshafy, Ahmed, Khaled Ibrahim Abdullah, Sherif Ashoush, and Heba E. Hosni. "The role of sildenafil citrate in the treatment of fetal growth restriction: a randomized controlled trial." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 5 (April 29, 2019): 1840. http://dx.doi.org/10.18203/2320-1770.ijrcog20191929.

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Background: This study was aimed to evaluate the effect of sildenafil citrate on Doppler velocity indices in patients with fetal growth restriction (FGR) associated with impaired placental circulation.Methods: A double-blinded, parallel group randomized clinical trial (clinicaltrials.gov NCT02590536) was conducted in Ain Shams Maternity Hospital, in the period between October 2015 and June 2017. Ninety pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were randomized to either sildenafil citrate 25 mg orally every 8 hours or placebo visually-identical placebo tablets with the same regimen. The primary outcome of the study was the change in umbilical artery and fetal middle cerebral artery indices.Results: There was a significant improvement in umbilical and middle cerebral artery indices after sildenafil administration p<0.001. Present study observed that, sildenafil group, in comparison to placebo, has a significantly higher mean neonatal birth weight. 1783±241g vs 1570±455g (p<0.001). There was a significantly higher mean gestational age at delivery in women in sildenafil group 35.3±1.67 weeks, whereas it was lower in the placebo group 33.5±1.7 weeks. The side effects as headache, palpitation and facial flushing were significantly higher in sildenafil group compared to placebo group.Conclusions: The use sildenafil citrate in pregnancies with fetal growth restriction (FGR) improved the feto-placental Doppler indices (pulsatility index of umbilical artery and middle cerebral artery) and improved neonatal outcomes.
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P., Chirtrarasan, and Kanagarameswarakumaran S. "Role of obstetric Doppler in prediction of adverse perinatal outcome in intrauterine growth retardation." International Journal of Advances in Medicine 4, no. 2 (March 23, 2017): 529. http://dx.doi.org/10.18203/2349-3933.ijam20171055.

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Background: Objective of current study was to determine and compare accuracy of various Doppler parameters for perinatal outcome. Umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) for predicting adverse perinatal outcome in patients of intrauterine growth retardation.Methods: 200 singleton pregnancies between 34 to 36 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery and ductus venosus. Patients kept under surveillance till confinement. According to increasing severity of Doppler indices categorized the cases into six grades from grade 0 to grade 5.Results: Out of 200 cases, 169 were live born and 24 were neonatal death. There were 5 cases of intrauterine death of foetuses and 2 were still born. Out of the live born 32 had increased perinatal morbidity like poor APGAR score, development of necrotizing enterocolitis, hypoxic ischemic encephalopathy, meconium aspiration syndrome, hyperbilirubinemia, and prolonged admission in neonatal care unit for reasons like sepsis / birth asphyxia.Conclusions: Absent end diastolic flow (EDF) / reversal in umbilical artery had high positive predictive value in predicting adverse foetal outcome. Ductus venosus changes seem to be an ominous sign of a severely compromised foetus with poor perinatal outcome. Doppler investigation of the MCA, UA and DV plays an important role in monitoring the compromised foetuses and helps to determine the optimal time of delivery.
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Temming, Lorene, Molly Stout, George Macones, Alison Cahill, Methodius Tuuli, and Nandini Raghuraman. "Umbilical Cord Oxygen Content and Neonatal Morbidity at Term." American Journal of Perinatology 35, no. 04 (October 11, 2017): 331–35. http://dx.doi.org/10.1055/s-0037-1607318.

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Objective The objective of this study was to investigate the relationship between umbilical cord partial pressure of oxygen (pO2) at delivery and neonatal morbidity. Study Design This is a secondary analysis of a prospective cohort study of term deliveries with universal cord gas collection between 2010 and 2014. The primary composite outcome of neonatal morbidity included neonatal death, meconium aspiration syndrome, intubation, mechanical ventilation, hypoxic-ischemic encephalopathy, and hypothermia treatment. Umbilical artery (UA), vein (UV), UV minus UA (Δ) pO2, and hypoxemia (pO2 ≤ fifth percentile) were compared between patients with and without neonatal morbidity. Areas under the receiver-operating characteristic curves were used to assess the predictive ability of pO2. Results Of 7,789 patients with paired umbilical cord pO2, 106 (1.4%) had the composite neonatal morbidity. UA pO2 was significantly lower in patients with neonatal morbidity compared with those without (median [interquartile range]: 16 (12, 21) vs. 19 (15, 24) mm Hg, p < 0.001). There was no difference in median UV pO2 or ΔpO2 between the groups. UA and UV hypoxemia were significantly more common in patients with neonatal morbidity. UA pO2 had limited predictive ability for neonatal morbidity (area under the curve: 0.61, 95% confidence interval: 0.6–0.7). Conclusion Although UA pO2 is significantly lower in patients with neonatal morbidity, it is a poor predictor of neonatal morbidity at term.
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B. R., Rekha, Pavanaganga A., Sai Lakshmi M. P. A., and Nagarathnamma R. "Comparison of Doppler findings and neonatal outcome in fetal growth restriction." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 3 (February 19, 2017): 955. http://dx.doi.org/10.18203/2320-1770.ijrcog20170563.

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Background: Fetal growth restriction (FGR) affects up to 5-10% of pregnancies. It is associated with increased perinatal mortality and morbidity. Doppler studies identify at risk fetuses and help in timing interventions and prognosticate outcomes. The ability of Doppler studies to predict neonatal outcome is studied here.Methods: Prospective study of seventy-two women with singleton pregnancies with gestational age above 28 week and detected to have FGR was done. The patients were subjected to Doppler analysis. Abnormal Doppler indices were compared with neonatal outcomes such as NICU admission, ventilator or CPAP support, sepsis, phototherapy and perinatal mortality.Results: Elevated umbilical artery PI, reduced middle cerebral artery PI and low CP ratio were found in 14, 18 and 36 fetuses. The sensitivity and specificity in predicting neonatal outcome was 25% & 75%, 58.1% and 62% and 17.9% and 75% for umbilical artery PI, MCA PI and CP ratio respectively. None of the Doppler indices showed significant p value. On testing, gestational age at delivery and length of NICU stay, gestational age was a significant determining factor with ‘p’ value of 0.003.Conclusions: Antenatal Doppler analysis of UA and MCA can predict neonatal outcome in FGR fetuses. Though the ‘p’ value was not significant in this study, the sensitivity, specificity, positive predictive value and negative predictive value are comparable to other studies. Gestational age at delivery significantly influences neonatal outcome.
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Sgorbini, Micaela, Francesca Bonelli, Giulia Percacini, Anna Pasquini, and Alessandra Rota. "Maternal and Neonatal Evaluation of Derived Reactive Oxygen Metabolites and Biological Antioxidant Potential in Donkey Mares and Foals." Animals 11, no. 10 (October 3, 2021): 2885. http://dx.doi.org/10.3390/ani11102885.

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Our aim was to measure the concentrations of derived reactive oxygen metabolite (d-ROMs) and biological antioxidant potential (BAP) of donkey mares and foals at delivery and to verify the protective role of the placenta against fetal oxidative stress. A total of 15 Amiata jennies with a physiological gestation length and delivery were included together with 17 foals (two twin foalings). After delivery, maternal and foal venous blood samples were collected along with blood from the artery. Circulating lactate and plasma d-ROMs and BAP were evaluated. The Wilcoxon test for paired data was applied to verify differences in d-ROMs and BAP values, while the Spearman test was used to evaluate correlations. A significantly higher d-ROMs concentration was found in jennies compared to their foals, and to the umbilical artery blood. The BAP was higher in jennies than in their foals, but no differences were observed in the umbilical artery blood. No difference was found between foals and their umbilical cord. Blood lactate was higher in foals than in their dams. Positive correlations were found between mares and umbilical cord for BAP and d-ROMs, and between mares and foals and umbilical cord for BAP. In conclusion, the placenta may be a protective factor for the fetus. As with equine foals, the antioxidant system of donkey foals does not seems to be effective at birth.
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Ferreira, Cátia, Ângela Melo, Ana Fachada, Helena Solheiro, and Nuno Nogueira Martins. "Umbilical Cord Blood Gas Analysis, Obstetric Performance and Perinatal Outcome." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 40, no. 12 (October 30, 2018): 740–48. http://dx.doi.org/10.1055/s-0038-1675187.

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Objective To analyze if umbilical artery pH (pHua) ≤7.00 and umbilical artery blood deficit (BDua) ≥12.00 mmol/L are good predictors of adverse neonatal outcomes. Methods This was an observational, longitudinal and retrospective cohort study, conducted at the department of obstetrics and gynecology of Centro Hospitalar Tondela Viseu between September 2013 and September 2015. Total cohort and subgroup analysis were performed: group A—women with umbilical cord blood gas analysis (UCBGA) performed for non-reassuring fetal cardiotocographic patterns, placental abruption, or shoulder dystocia; and group B—all the others. Assays were made with the software SPSS for Windows, Versions 20.0 and 21.0 (IBM Corp., Armonk, NY, USA). Results A total of 428 UCBGAs met the inclusion criteria. The group analysis revealed an association between group A and pHua ≤7.00, as well as between BDua ≥12.00 mmol/L and 1st minute Apgar score ≤4 (p = 0.011). After the application of the logistic regression models in the total cohort analysis, pHua ≤7.00 had an impact in the occurrence of acute neonatal hypoxia (odds ratio [OR]: 6.71; 95% confidence interval [CI]: 1.21–37.06; p = 0.029); multiparous women had a higher risk of delivering a newborn with first minute Apgar score ≤4 and acute neonatal hypoxia (OR: 5.38; 95% CI: 1.35–21.43; p = 0.017; and OR: 2.66; 95% CI: 1.03–6.89, p = 0.043, respectively); women who had urologic problems during pregnancy had a higher risk of delivering a newborn with 5th minute Apgar score ≤7 (OR: 15.17; 95% CI: 1.29–177.99; p = 0.030); and shoulder dystocia represented a 15 times higher risk of acute neonatal hypoxia (OR: 14.82; 95% CI: 2.20–99.60; p = 0.006). Conclusion The pHua and the BDua are predictors of adverse neonatal outcome, and UCBGA is a useful tool for screening newborns at risk. Universal UCBGA should be considered for all deliveries, as it is an accurate screening test for neonatal hypoxia.
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Fellmeth, BD, MP Sandler, GA Thieme, AC Fleischer, and WW Neblett. "Noninvasive evaluation of neonatal aortic thrombosis secondary to umbilical artery catheterization." American Journal of Roentgenology 146, no. 3 (March 1986): 619–20. http://dx.doi.org/10.2214/ajr.146.3.619.

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Kitano, Taito, Ayako Ohgitani, Kumiko Takagi, Ikuyo Arai, Hajime Yasuhara, Reiko Ebisu, Yoshinori Takeda, Satoko Ishibashi, Kohei Morita, and Hideki Minowa. "A case of severe neonatal asphyxia due to umbilical artery thrombosis." Journal of Obstetrics and Gynaecology 38, no. 8 (March 7, 2018): 1164–65. http://dx.doi.org/10.1080/01443615.2017.1404012.

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Lane, Indy W., Haywood L. Brown, and Kinney A. Hiett. "Neonatal Outcome of Infants With Significant Umbilical Artery Acidosis at Birth." Obstetrics & Gynecology 101, Supplement (April 2003): 72S—73S. http://dx.doi.org/10.1097/00006250-200304001-00170.

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van den Berg, Paul P., Willianne L. D. M. Nelen, Henk W. Jongsma, Roel Nijland, Louis A. A. Kollée, Jan G. Nijhuis, and Tom K. A. B. Eskes. "Neonatal complications in newborns with an umbilical artery pH <7.00." American Journal of Obstetrics and Gynecology 175, no. 5 (November 1996): 1152–57. http://dx.doi.org/10.1016/s0002-9378(96)70021-2.

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LANE, I. "Neonatal outcome of infants with significant umbilical artery acidosis at birth." Obstetrics & Gynecology 101, no. 4 (April 2003): S72—S73. http://dx.doi.org/10.1016/s0029-7844(02)02930-7.

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Andraweera, P. H., G. A. Dekker, R. C. Nowak, S. D. Thompson, L. M. E. McCowan, R. A. North, and C. T. Roberts. "113. VASCULAR ENDOTHELIAL GROWTH FACTOR GENE POLYMORPHISMS IN PLACENTAL IMPAIRMENT AND SMALL FOR GESTATIONAL AGE BIRTH." Reproduction, Fertility and Development 22, no. 9 (2010): 31. http://dx.doi.org/10.1071/srb10abs113.

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Impaired placental angiogenesis is implicated in the pathophysiology of small for gestational age (SGA) infants. Placental expression of vascular endothelial growth factor (VEGF), a potent angiogenic factor, is reduced in SGA pregnancies. We aimed to evaluate the association of two single nucleotide polymorphisms (SNPs, VEGF-2578C/A and VEGF+936C/T) in VEGF gene which reduce VEGF expression, in SGA pregnancies andexamine their effects on first trimester placental VEGF expression. 3196 nulliparous pregnant women, their partners and babies were recruited in Adelaide and Auckland to a prospective multicentre cohort study (SCOPE Study). Amongst 2123 Caucasian women, 216 (11.9%) delivered a SGA infant defined as <10th customised centile. Uncomplicated Caucasian pregnancies served as controls (n = 1176). Uterine and umbilical artery Doppler velocimetry was performed at 20 weeks gestation. DNA extracted from peripheral blood from couples and cord blood from babies was genotyped using Sequenom MassARRAY. 74 first trimester placentae collected from elective terminations of pregnancy were genotyped for the same SNPs and the VEGF expression determined by RT-PCR. Neonatal VEGF+936 CT+TT genotypes associate with SGA (OR 1.6, 95%CI 1.1–2.3), lower birthweight (P = 0.005), customised birthweight centile (p=0.03), lower placental weight (P = 0.04) and an increased uterine artery resistance index (RI, P = 0.004). Maternal VEGF+936 CT+TT associate with bilateral notching of the uterine artery waveform (OR 1.4, 95%CI 1.0–1.8) and an increased umbilical artery RI (OR 1.5, 95%CI 1.1–2.1). VEGF+936 CT first trimester placentae have lower VEGF expression compared to CC (P = 0.045). Neonatal VEGF-2578 AA associates with bilateral uterine artery notching (OR 1.5, 95%CI 1.1–2.2) and increased umbilical artery RI (OR 1.6, 95%CI 1.0–2.6). Maternal VEGF-2578 CA+AA associate with increased umbilical artery RI (OR 1.5, 95%CI 1.0–2.2). VEGF polymorphisms reduce first trimester VEGF expression and associate with increased resistance in the placental circulation suggesting impaired placental function. VEGF+936 SNP confers increased risk for SGA.
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Elboraee, Mohamed, Jennifer Toye, Xiang Ye, Prakesh Shah, and Khalid Aziz. "Association between Umbilical Catheters and Neonatal Outcomes in Extremely Preterm Infants." American Journal of Perinatology 35, no. 03 (September 14, 2017): 233–41. http://dx.doi.org/10.1055/s-0037-1606607.

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Objective The objective of this study was to examine the association between umbilical catheters and a composite outcome of mortality or major neonatal morbidity in extremely preterm infants. Study Design Data were abstracted from the Canadian Neonatal Network database for infants born at <29 weeks' gestational age and admitted to 29 neonatal intensive care units between January 2010 and December 2012. Four groups were identified: those with no umbilical catheters, umbilical venous catheters (UVCs), umbilical artery catheters (UACs), and those with both UVCs and UACs. The outcomes were compared among the groups using univariate and multivariable analyses. Results Of 4,623 eligible infants, 820 (17.7%) had no catheters, 1,032 (22.3%) a UVC only, 120 (2.6%) a UAC only, and 2,651 (57.3%) had both catheters. After adjustment for acuity and other potential confounders, umbilical catheters were associated with higher odds of mortality or any major morbidity (UVC vs. no catheter: adjusted odds ratio [aOR]: 1.47; 95% CI: 1.18–1.85; UAC vs. no catheter: aOR: 1.67; 95% CI: 1.05–2.63; and both UVC + UAC vs. no catheter: aOR: 2.17; 95% CI: 1.79–2.70). Conclusion Most of the infants born at <29 weeks' gestation had UVC and/or UAC placement. The presence of either catheter was associated with mortality or major morbidity, and the association was stronger when both catheters were present.
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z, Senem, Murat Cengiz, G. Tuncay, and Abdullah Karaer. "Comparison of umbilical coiling index in term pregnancies with and without fetal growth restriction." Annals of Medical Research 29, no. 7 (2022): 1. http://dx.doi.org/10.5455/annalsmedres.2021.12.657.

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Objective: To investigate pregnancies with and without fetal growth restriction, giving birth after 37 weeks of gestation in terms of umbilical coiling index and neonatal outcomes. Materials and Methods: Twenty-nine patients with fetal growth restriction and 46 patients who have normal pregnancy and delivered after the 37th week of gestation were recruited in this study. The umbilical coiling index was measured by ultrasound, following the patients who were hospitalized for delivery. Results: There were statistically significant differences between the groups regarding to umbilical artery pulsatility index, gestational age at delivery and birth weight of the newborn. The need for a cesarean section because of non-reassuring fetal condition was statistically significantly higher in the fetal growth restriction group. The mean antenatal umbilical coiling index in fetal growth restriction and control patients was 0.29±0.08 and 0.27±0.08, respectively and the difference was not statistically significant. Conclusion: There was no statistically significant difference between the patients diagnosed with and without fetal growth restriction who delivered after the 37th gestational week, regarding the umbilical coiling index and perinatal outcomes, except umbilical artery pulsatility index, gestational age at birth and birth weight of the newborn.
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LEVY, BARCEY T., JEFFREY D. DAWSON, PETER P. TOTH, and NOELLE BOWDLER. "Predictors of Neonatal Resuscitation, Low Apgar Scores, and Umbilical Artery pH Among Growth-Restricted Neonates." Obstetrics & Gynecology 91, no. 6 (June 1998): 909–16. http://dx.doi.org/10.1097/00006250-199806000-00007.

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Levy, B. "Predictors of Neonatal Resuscitation, Low Apgar Scores, and Umbilical Artery pH Among Growth-Restricted Neonates." Obstetrics & Gynecology 91, no. 6 (June 1998): 909–16. http://dx.doi.org/10.1016/s0029-7844(98)00094-5.

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46

Nair, Bindu T., and Uma Raju. "Study of Correlation of Neonatal Outcomes with Gross Abnormalities of Placenta and Umbilical Cord." Journal of Nepal Paediatric Society 37, no. 3 (June 7, 2018): 254–60. http://dx.doi.org/10.3126/jnps.v37i3.17637.

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Introduction: Perinatal outcome of new-borns is greatly influenced by abnormalities of placenta and umbilical cord. In most of the deliveries, whether home or institutional, the placenta and umbilical cords are discarded without examination. Due to paucity of information on abnormalities of placenta and cord, there is hardly any correlation with foetal outcomes. The aim was to study the correlation between the foetal outcome and the different types of abnormalities of placenta and umbilical cord.Materials and Methods: A prospective, cross-sectional, descriptive, randomised study was conducted from January 2016 to December 2016 in a tertiary care hospital in North India. The study was carried out on 1000 term singleton newborns. The placenta and umbilical cords were obtained from both normal and caesarean section deliveries. A proforma was used to gather data from the patients and new-borns. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc, Chicago, IL, IBM version) along with Microsoft Excel (2010 version).Results: One thousand placentae and umbilical cords were examined of which high placental weight/birth weight ratio, gross anomalies of placenta (infarctions, calcifications and retro placental haematoma), marginal (battledore and velamentous) umbilical cord insertions, long umbilical cords and single umbilical artery were associated with negative foetal outcomes.Conclusions: There was a high incidence of adverse foetal outcome with placental and umbilical cord abnormalities. Education of our health personnel dealing with deliveries on the importance of proper examination of the placenta and umbilical cords should be emphasised and instituted upon.
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Obut, Mehmet, Asya Kalaycı Öncü, Özge Yücel Çelik, Arife Akay, Güliz Özcan, Gülşah Aynaoğlu Yıldız, Can Tekin İskender, and Ali Turhan Çağlar. "Prenatal and neonatal outcomes of pregnancies diagnosed with fetal single umbilical artery." Perinatal Journal 29, no. 3 (December 3, 2021): 217–24. http://dx.doi.org/10.2399/prn.21.0293007.

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Objective To investigate the associated anomalies and outcomes of fetuses diagnosed as having a single umbilical artery (SUA) which were reported inconsistently in previous studies. Methods The data of 82 pregnancies with fetal SUA, 35 of which were complex, and 47 isolated SUA (iSUA) and 100 pregnancies with fetal double umbilical arteries (DUA) between June 2018 and July 2020 were retrieved. We compared the maternal characteristics, and pregnancy and fetal outcomes of the three groups (iSUA, SUA, and DUA). Results Of 82 fetuses with SUA, 35 had 64 major structural abnormalities. 20 of these 35 fetuses (57.1%) had cardiovascular malformations, 12 (34.2%) had central nervous, 10 (28.5%) had genitourinary, and eight (22.8%) had gastrointestinal system malformations. Isolated SUA was present in SUA. Compared with the 100 DUA fetuses, SUA was a risk for intrauterine growth restriction (IUGR), preterm delivery, Apgar scores of <7, and admission to the neonatal intensive care unit. Having fetal chromosomal or structural abnormalities, was a risk for amnion fluid abnormality, pregnancy termination, intrauterine fetal death, early neonatal death, and a low live birth ratio in SUA cases. Conclusion SUA has an increased rate of fetal structural and chromosomal abnormalities. Among them, the most detected one is cardiac and the second most common one is central nervous system malformations. Pregnancies with fetal SUA have increased risk for IUGR, preterm delivery, low Apgar scores, and admission to the neonatal intensive care unit. The presence of additional structural or chromosomal malformations increases the rate of these adverse pregnancy risks. Thus, these cases warrant dedicated fetal ultrasonographic organ screening and close prenatal follow-up.
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Makhseed, M., J. Jirous, M. A. Ahmed, and D. L. Viswanathan. "Middle cerebral artery to umbilical artery resistance index ratio in the prediction of neonatal outcome." International Journal of Gynecology & Obstetrics 71, no. 2 (November 2000): 119–25. http://dx.doi.org/10.1016/s0020-7292(00)00262-9.

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Gandhi, Garima, and Kavita Chandnani. "Association between clinical diagnosis of foetal distress with umbilical artery acidaemia at birth in women undergoing caesarean section for foetal distress." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 6 (May 28, 2019): 2393. http://dx.doi.org/10.18203/2320-1770.ijrcog20192437.

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Background: The risks of maternal morbidity and mortality associated with a caesarean section may not be reasonably justified by the degree of neonatal compromise at birth associated with caesarean section done for clinically diagnosed foetal distress. The aim was to study the association of clinical diagnosis of non-reassuring foetal status with umbilical artery acidaemia at birth in women undergoing caesarean section for foetal distress and to evaluate outcomes in neonates born by caesarean section performed for foetal distress.Methods: Prospective observational study of all the women undergoing emergency caesarean section for foetal distress at a tertiary care teaching facility over 2 months. Criteria for diagnosis of foetal distress were thick meconium stained liquor only or foetal heart rate abnormality with or without meconium stained liquor. Testing for pH was done on arterial blood drawn from umbilical cord at the time of birth. Acidaemia was defined as cord blood pH less than 7.2. Severe acidaemia was defined as cord blood pH less than 7.0.Results: Cord blood pH was analysed in 110 caesareans done for foetal distress. Incidence of neonatal acidaemia at birth in study population was 53.6%.Conclusions: Much lower incidence of actual acidaemia and low Apgar scores in neonates born by caesarean section done for clinical diagnosis of foetal distress than previously reported indicate the need for more stringent criteria and more objective tests for diagnosis of foetal distress.
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Sarwar, Andleeb, Huma Afridi, Beenish Riaz, and Itaat Ullah Khan Afridi. "Association of Adverse Outcomes with Abnormal Umbilical Artery Waveform in Intrauterine Growth Restricted Pregnancies." Pakistan Journal of Medical and Health Sciences 15, no. 9 (September 30, 2021): 2340–42. http://dx.doi.org/10.53350/pjmhs211592340.

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Background: Intrauterine growth restriction refers to a fetus with a fetal weight in the 10th percentile on ultrasonography who has not reached its biologically set growth potential due to a pathologic condition. Aim: To determine the association of adverse outcome with abnormal umbilical artery waveform groups in intrauterine growth restricted pregnancies. Methods: This Cohort Study was conducted from February 2019 to 12 February 2020 at Gynae & Obs Department, Imran Idrees Teaching Hospital Sialkot, Sialkot Medical College, Sialkot 120 pregnant females, attending Department of Gynae & Obs were recruited into the study after 28 weeks of gestation. The women were divided into two groups depending on their Doppler findings. One group (exposed) comprised of women with intrauterine growth restriction, with absent or reversed diastolic flow in the umbilical artery. The control (unexposed) group included women with small-for-date fetuses, with normal umbilical artery Doppler flow. Results: The mean age of females was 27.40 ± 4.77 years. The mean gestational age was 30.69 ± 2.19 weeks. The mean birth weight of neonates was 2.37 ± 0.90 kg. The mean AGPAR score of neonates was 6.60 ± 1.70. It was observed that there was significant association between groups and low birth weight with p-value = 0.002. Admissions to NICU were significantly lower in normal Doppler wave form group having p-value = 0.001. Conclusion: The percentage of NICU admission was 46.7% and the percentage of low birth weight was 46.7% in intrauterine growth restriction. The mean birth weight was significantly lower in exposed group and the mean APGAR score was also significantly lower in exposed group. Keywords: Apgar score, neonatal intensive care unit, Intrauterine Growth Restriction, Doppler ultrasound,
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