Journal of Ultrasound in Medicine, Vol 10, Issue 6 337-339, Copyright © 1991 by American Institute of Ultrasound in Medicine
Value of a random single Doppler study of the umbilical artery for predicting perinatal outcome
J. S. Abramowicz, S. L. Warsof, D. M. Sherer, D. L. Levy and J. R. Woods Jr
Division of Maternal-Fetal Medicine, University of Rochester Medical Center, New York.
A prospective blinded study was performed on 191 high-risk patients with
pregnancies ranging from 25 to 42 weeks gestation to investigate the value
of a single Doppler analysis of the umbilical artery blood flow waveform
(systolic-to-diastolic ratio, S/D) for predicting poor perinatal outcome.
This was defined as the presence of heavy meconium, delivery of a
growth-retarded infant, an umbilical cord arterial pH less than 7.2, or a
5-minute Apgar score less than 7. The interval between Doppler examination
and delivery ranged from 12 hours to 15 weeks. No clinical data were
available to the examiner performing the Doppler study. Moreover, the
Doppler measurements were unknown to the attending physicians. The
sensitivity, specificity, and positive and negative predictive values of
the Doppler study in predicting outcome were 30.4%, 92.9%, 36.8%, and
92.6%, respectively, with an adverse outcome prevalence of 12%. These
results indicate that a single random S/D ratio from the umbilical artery
is not an adequate screening test for the risk of perinatal complications.
