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Related Experiment Videos

Umbilical artery pulsatility index: reliability at different sampling sites.

Francesc Figueras1, Susana Fernandez, Elisenda Eixarch

  • 1Department of Obstetrics, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona, Spain. figuerasfrancesc@telefonica.net

Journal of Perinatal Medicine
|September 13, 2006
PubMed
Summary

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The perivesical site for umbilical artery (UA) pulsatility index (PI) measurement offers better reliability than the placental end. Evaluating both UA segments is crucial due to increased PI discordance at the perivesical site.

Area of Science:

  • Perinatology
  • Fetal Medicine
  • Medical Imaging

Background:

  • Umbilical artery (UA) pulsatility index (PI) is a key indicator of fetal well-being.
  • Accurate PI measurement is essential for timely clinical decisions.
  • Variability in measurement techniques can affect reliability.

Purpose of the Study:

  • To assess the inter-observer and inter-artery reliability of UA PI measurements.
  • To compare the reliability of UA PI at three distinct sampling sites: placental end, free-floating loop, and perivesical segment.

Main Methods:

  • Prospective study including 100 singleton pregnancies (24-40 weeks).
  • Two independent operators measured UA PI in both umbilical arteries at three sites.
  • Reliability analyses (inter-observer and inter-artery) were conducted for each site.

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Main Results:

  • The perivesical site showed higher Intraclass correlation coefficients (0.67) compared to the free-loop (0.59) and placental end (0.51).
  • Mean PI differences between arteries were 15.2% (placental), 14.5% (free-loop), and 22% (perivesical).
  • Greater than 20% PI difference between arteries occurred in ~20% of cases at the placental and free-loop sites, and 45% at the perivesical site.

Conclusions:

  • The perivesical sampling site demonstrates superior, though not always statistically significant, reliability for UA PI compared to the free-floating loop and placental end.
  • Despite higher reliability, the perivesical site exhibits more pronounced PI discordance between the two umbilical arteries.
  • Bilateral assessment of the umbilical arteries at the perivesical segment is recommended for accurate PI evaluation.