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Long term predictive value of Doppler studies in high risk fetuses
D C Wilson1, A Harper, G McClure
1Neonatal Intensive Care Unit, Royal Maternity Hospital, Belfast, N. Ireland.
Objective:
To determine whether the predictive value of Doppler ultrasonography extends beyond the perinatal period.
Design:
Descriptive follow-up study.
Setting:
Specially designated paediatric clinic in Royal Maternity Hospital.
Subjects:
40 children who as high risk fetuses had had assessment of umbilical artery flow velocity waveforms.
Interventions:
Parental history, physical examination, anthropometry, Denver developmental screening test.
Outcome Measures:
Weight, height, head circumference, neurological impairment, Denver development screening test
Result:
Abnormal waveforms were an accurate predictor of neonatal outcome, with significant differences in birthweight, gestational age, need for nursery admission, and frequency of intrauterine growth retardation between normal and abnormal waveform groups. However, abnormal Doppler studies were not predictive of long-term adverse sequelae. There were no significant differences in height, head circumference, proportion with neurological impairment, or results of Denver developmental screening test at a median age of five years.
Conclusion:
The predictive value of Doppler ultrasonography is less for long-term growth and neurodevelopment than for perinatal outcome in the high risk fetus.