[Evaluation of fetal well-being using a modified Doppler flowmetric profile]. 2000

G Romero Gutiérrez, and A Vargas Origel, and J Zamora Orozco, and M R Alvarado López
Unidad de Investigación en Epidemiología Clínica, Hospital de Gineco-Pediatria Número 48 León, Guanajuato.

Decreasing perinatal morbimortality rates still represents an essential objective of antenatal care, so better diagnostic test for detecting fetal well-being are needed. The aim of this study was to compare a modified Doppler Ultrasonography Profile (DUP) with the Manning Fetal Biophysical Profile (FBP). One hundred and thirty eight high risk pregnant women between 38 and 42 gestational age, were prospectively studied with the proposed technique. The modified DUP is a quick-easy method that included five variables: umbilical Doppler velocimetry, amniotic fluid volume, fetal movements, placental grading and fetal growth pattern. The modified DUP diagnostic accuracy was compared with FBP diagnostic accuracy and a logistical regression analysis was performed to find predictors of fetal well-being. The sensitivity, specificity, and positive and negative predictive values of DUP in predicting perinatal outcome were 28%, 97%, 40% and 96.2%, respectively. On the other hand sensitivity, specificity, and positive and negative predictive values of the FBP were: 20%, 91%, 11% and 95.6%, respectively. The 95% confidence intervals for sensitivity and specificity wore 20.7-25.2 and 94.5-99.4, for the modified DUP whereas were obtained for FBP 12.2-27.7 and 85.6-96.3. The concordance between evaluated tests was 89%, with a Kappa value of 0.80. The multivariate logistical analysis showed two predictor variables as significant in the modified DUP model (umbilical Doppler velocimetry, P < 0.05, and fetal growth pattern, P < 0.05) but in the FBP no parameter reached statistical significance. Although the modified DUP had better diagnostic values an overlapping was clearly found in 95% confidence intervals, therefore it was concluded that the modified DUP proposed had similar diagnostic accuracy as FBP and could be alternatively used for assessing fetal well-being in high-risk pregnancies.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005260 Female Females
D005323 Fetal Monitoring Physiologic or biochemical monitoring of the fetus. It is usually done during LABOR, OBSTETRIC and may be performed in conjunction with the monitoring of uterine activity. It may also be performed prenatally as when the mother is undergoing surgery. Monitoring, Fetal,Fetal Monitorings,Monitorings, Fetal
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012680 Sensitivity and Specificity Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed) Specificity,Sensitivity,Specificity and Sensitivity

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