Umbilical Doppler: predictive value in acute fetal distress in case of prolonged pregnancy

Introduction 

to improve the management of prolonged pregnancy, a detailed study of the predictive value of umbilical Doppler in acute fetal distress should allow good behavior and state route of delivery.

Objective

Determine if high index of resistance at the umbilical artery is predictive of adverse neonatal outcome.

Methods

A prospective study was conducted in our department over a period of four months including all women admitted for delivery over a period of 41 weeks gestation or more. Obstetric ultrasound thus measuring the resistance index in the umbilical artery was performed at admission in all parturient. A correlation study was conducted to clarify the predictive value of Doppler in fetal distress.

Results

139 patients were enrolled with a mean age of 29.38 years. The medium-term admission is 41 weeks gestation and 2 days or 289 days. A pathologic admission umbilical Doppler was noted in 33 patients. A total of 13 newborns showed acute fetal distress during labor and 6 among them transferred in neonatology. We found a low sensitivity of Doppler, in the order of 38.46% and a specificity of 77.77%. The positive predictive value was 15.15%, but the negative predictive value was 92.45%.

Conclusion 

our study has shown the bad predictive value of umbilical Doppler in fetal distress. Given its specificity and negative predictive value, the umbilical Doppler remains a good review monitoring in case of prolonged pregnancy.

Keywords

Fetus, Doppler