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Journals / Perinatoloji Dergisi / 2005 / Cilt: 13 - Sayı: 4

Relationship between umbilical artery Doppler investigations and perinatal outcome in patients with HELLP syndrome

HELLP sendromlu hastalarda umbilikal arter Doppler incelemesinin perinatal sonuçlarla ilişkisi

Mekin SEZİK
Mehmet Okan ÖZKAYA
Hülya Toyran SEZİK
Elif Gül YAPAR
Hakan KAYA
Pages
198–202
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Normal umbilical blood flow in HELLP syndrome may demonstrate a low risk for perinatal mortality.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: To investigate the association between umbilical artery Doppler studies and subsequent perinatal mortality in pregnancies with HELLP syndrome.
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Key Findings & Data:Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of S/D ≥5 and AREDF during umbilical artery doppler investigations for the prediction of perinatal mortality were calculated.
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Conclusion & Impact:Normal umbilical blood flow in HELLP syndrome may demonstrate a low risk for perinatal mortality.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Bebek ölüm oranı · Testlerin kestirim değeri · Geriyedönük çalışma

Abstract

Objective: To investigate the association between umbilical artery Doppler studies and subsequent perinatal mortality in pregnancies with HELLP syndrome. Methods: Seventy-seven women with HELLP syndrome were retrospectively evaluated regarding systole/diastole (S/D) ratios and presence of absent or reverse end-diastolic flow (AREDF) on umbilical artery Doppler velocimetry. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of S/D ≥5 and AREDF during umbilical artery doppler investigations for the prediction of perinatal mortality were calculated. Results: Cesarean section rate was 76% (n=57). Indications for cesarean delivery were obstetric causes in 6 women (10.5%) and fetal distress or HELLP syndrome in the remaining patients. Prenatal loss rate was 18% (n=14). There were 4 (6.3%) neonatal deaths out of 63 live-born infants. Sensitivity, specificity, PPV, and NPV of S/D ratio ≥5 on umbilical artery doppler velocimetry for predicting subsequent perinatal mortality was 85.7%, 66.7%, 36.3%, and 95.5%, respectively. Sensitivity, specificity, PPV, and NPV of the presence of AREDV on umbilical artery Doppler velocimetry for predicting subsequent perinatal mortality was 71.4%, 82.5%, 47.6%, and 92.8%, respectively. Conclusions: Umbilical artery Doppler investigations might be essential for evaluating the risk of perinatal mortality and timing of delivery in patients with HELLP syndrome. Normal umbilical blood flow in HELLP syndrome may demonstrate a low risk for perinatal mortality.

Özet

Amaç: HELLP sendromlu hastalarda umbilikal arter Doppler inceleme sonuçlarının, perinatal ve postnatal dönem fetal iyilik hali göstergeleri ile olan ilişkisini belirlemektir. Yöntem: Yetmiş yedi HELLP sendromlu hasta retrospektif olarak incelendi. Doppler incelemesinde Sistol/Diastol (S/D) oranı ile diastolik akım yokluğu (DAY) ve ters akım (TA) varlığı durumları araştırıldı. Umbilikal arter Doppler incelemesinde S/D ?5 ve DAYTA olması durumunun perinatal mortaliteyi belirleyebilmesindeki sensitivite, spesifisite, pozitif prediktif değer (PPD) ve negatif prediktif değeri (NPD) hesaplandı. Bulgular: Sezaryen oranı %74 (57) idi. Sezaryen ile doğurtulanlardan 6 (%10.5)'sı obstetrik endikasyonlarla sezaryen olurken, geri kalanlarda endikasyonu fetal distress ve HELLP sendromuna bağlı maternal patolojiler oluşturmaktaydı. Toplam 77 hastanın 14'ünde (%18) takip sırasında prenatal kayıp gerçekleşti. Canlı doğan 63 bebekten 4 (%6.3)'ü postpartum dönemde kaybedildi. Umbilikal arter Doppler (UAD) S/D ?5 olmasının perinatal mortalite riskini belirlemedeki sensitivitesi %85.7, spesivitesi %66.7, PPD'i %36.3 ve NPD'i %95.5, UAD incelemesinde DAYTA olması durumunda ise sensitivite %71.4, spesifisite %82.5, PPD %47.6 ve NPD %92.8 olarak saptandı. Sonuç: HELLP sendromunun anne ve fetus açısından taşıdığı riskler göz önüne alındığında, bu gebelerde umbilikal arter Doppler incelemesi hem perinatal mortalite riskinin belirlenmesi, hem de doğum zamanın planlanması için önemlidir. Normal umbilikal arter Doppler akımı olması perinatal mortalitenin daha az olmasının göstergesi olabilir.

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Cite This Article

SEZİK, M., ÖZKAYA, M. O., SEZİK, H. T., YAPAR, E. G., KAYA, H. (2005). Relationship between umbilical artery Doppler investigations and perinatal outcome in patients with HELLP syndrome. Perinatoloji Dergisi, Cilt: 13 - Sayı: 4, 198–202. https://ajindex.com/articles/300377

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