Doppler velocimetry and fetal well-being assessment exams performance’s study for adverse neonatal outcomes

Abstract

The aim of this retrospective study was to assess the role prenatal exams topredict neonatal adverse outcomes. The sample was divided according to maternal and gestational complications, as placental insufficiency ethiology. Furthermore, the predictive values of the exams were analyzed in relation to postnatal adverse outcomes. The sample was constituted by 1,387 high-risk pregnancies assisted in the Obstetrics Department - Fetal Well-being Assessment Section of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - Brazil. The performance of all prenatal enrolled exams were evaluated in order to predict the adverse postnatal outcomes, using sensitivity, specificity,PPV and NPV estimations. The population approach was executed in two different subgroups,stratified according to the risk imposed by the obstetrical disease or complication. 659 casesand high-risk subgroup, 728 cases constituted the low-risk subgroup. The prenatal exams were: UA Doppler, middle cerebral artery Doppler, ductus venosus Doppler, cardiotocography and fetal biophysical profile. The postnatal results were: prematurity index, intrauterine growth restriction, neonatal asphyxia (Apgar < 7) and acidemia at delivery. As far as the test performance is regarded, all of them demonstrated best results in the high-risk subgroup thanin the low-risk subgroup. In regarding to all postnatal abnormalities diagnosis, the UA Dopplerperformance was the best when compared with all other exams.