Assessment of uterine artery and aortic isthmus Doppler recordings as predictors of necrotizing enterocolitis

作者：Raboisson Marie Jose; Huissoud Cyril; Lapointe Annie; Hugues Nicolas; Bigras Jean Luc; Brassard Myriam; Lamoureux Julie; Fouron Jean Claude^*

来源：American Journal of Obstetrics and Gynecology, 2012, 206(3): 232.e1.

DOI：10.1016/j.ajog.2011.11.005

• aortic isthmus
• Doppler assessment
• intrauterine growth restriction
• necrotizing enterocolitis
• uterine artery

OBJECTIVE: The purpose of this study was to evaluate whether changes of uterine arteries and aortic isthmus Doppler blood flow recordings could enhance the prediction of necrotizing enterocolitis. %26lt;br%26gt;STUDY DESIGN: Doppler characteristics of the uterine artery, umbilical and middle cerebral arteries, ductus venosus, and aortic isthmus were reviewed in 123 growth-restricted fetuses who were then divided into 2 groups: with and without necrotizing enterocolitis. %26lt;br%26gt;RESULTS: Twelve of 123 newborn infants (9%) expressed necrotizing enterocolitis. This group showed significant association between necrotizing enterocolitis and bilateral notching on the uterine artery (83.3% vs 29.7%; P %26lt; .001), uterine artery mean resistance index (83.3% vs 36.9%; P %26lt; .002), aortic isthmus diastolic blood flow velocity integrals (Z score: -7.32 vs -3.99; P = .028), and absent or negative %26quot;a%26quot; wave on the ductus venosus (17% vs 1.8%; P = .021). With the use of logistic regression, uterine bilateral notching could predict necrotizing enterocolitis with a sensitivity of 83.3% and a specificity of 70.3%. %26lt;br%26gt;CONCLUSION: More than any other variable, uterine bilateral notching should be recognized as a strong risk factor for necrotizing enterocolitis.

• 出版日期2012-3