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Related Concept Videos

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Fetal Circulation

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Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
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Related Experiment Video

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Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
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Fetal Doppler Evaluation to Predict NEC Development.

Miriam Duci1, Erich Cosmi2, Pierpaolo Zorzato2

  • 1Department of Women's and Children's, Division of Paediatric Surgery, University of Padua, 35100 Padua, Italy.

Journal of Personalized Medicine
|July 27, 2022
PubMed
Summary

Fetal ductus venosus Doppler (DV) and Fenton z-scores can predict necrotizing enterocolitis (NEC) in fetuses with fetal growth restriction (FGR). These antenatal factors offer valuable insights for early intervention and improved outcomes.

Keywords:
Doppler flow velocimetryfetal growth restrictionnecrotizing enterocolitispredictive valuespremature

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Area of Science:

  • Perinatology
  • Neonatology
  • Fetal Medicine

Background:

  • Antenatal factors are implicated in the pathogenesis of necrotizing enterocolitis (NEC).
  • Fetal growth restriction (FGR) is a known risk factor for adverse neonatal outcomes, including NEC.
  • Early prediction of NEC in FGR fetuses is crucial for timely intervention.

Purpose of the Study:

  • To evaluate the predictive value of fetal ductus venosus Doppler (DV) for NEC in fetuses with FGR.
  • To assess the accuracy of IG21 and Fenton growth curves in predicting NEC development.
  • To identify key antenatal predictors of NEC in FGR fetuses.

Main Methods:

  • Retrospective cohort study of FGR fetuses (2010-2020) at a single center.
  • Collected data on antenatal factors, fetal Doppler characteristics, and postnatal outcomes.
  • Compared fetuses with and without NEC using bivariate and multivariate analyses.

Main Results:

  • Absent or reversed end-diastolic flow (AREDF) and increased DV resistance were significantly associated with NEC.
  • Lower Fenton z-scores were observed in NEC cases compared to controls.
  • A predictive model including Fenton z-score, white blood cells (WBC), persistent patent ductus arteriosus (PDA), and DV achieved an AUC of 84%.

Conclusions:

  • Fetal Doppler findings, particularly DV assessment, are effective in predicting NEC in FGR fetuses.
  • The Fenton z-score demonstrated high sensitivity as a predictive factor for NEC.
  • Combining fetal growth assessment with Doppler and postnatal factors improves NEC prediction accuracy.