An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour

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dc.contributor.advisorLindow, Stephenen_ZA
dc.contributor.advisorVan der Elst, Cliveen_ZA
dc.contributor.authorStuart, Ian Peteren_ZA
dc.date.accessioned2018-01-30T13:59:53Z
dc.date.available2018-01-30T13:59:53Z
dc.date.issued1993en_ZA
dc.description.abstractIntroduction: An assessment of the role of Doppler ultrasound velocity waveform analysis of the fetal umbilical arteries in the diagnosis of fetal distress in labour is made from a review of the literature and clinical study. Study objectives: 1) To determine the value of screening with Doppler ultrasound in high-risk labours in the prediction of the development of indicators of fetal distress. 2) To determine whether Doppler velocimetry indices of the umbilical arteries change with the development of indicators of fetal distress in labour. Design: Repeated Doppler velocimetry in selected high risk labours. Setting: Groote Schuur Hospital, Cape Town, South Africa, a large tertiary referral centre. Subjects: Thirty six women with singleton pregnancies complicated either by gestational proteinuric hypertension or by intrauterine growth retardation or both with a normal cardiotocographic tracing at the onset of labour. Main outcome measures: 1) Acid-base status of the fetus was assessed after deli very by analysis of umbilical artery blood. 2) Apgar score was recorded at 1 and 5 minutes. 3) Neonates were carefully examined for clinical signs of perinatal hypoxia. Results: Twenty seven fetuses were followed through labour. No relation was found between umbilical artery Pourcelot ratio (resistance index) on admission in labour and umbilical artery base deficit. Six fetuses were born with an umbilical artery base deficit of more than 10 mmol 1-1. Zero change in mean Pourcelot ratio was noted in both normal and acidotic fetuses. None of the acidotic fetuses showed a change in Pourcelot ratio of more than 0.03. The study had an 80% power to detect a change in mean Pourcelot ratio of 0.07 in the normal fetuses and 0.16 in the acidotic fetuses at a 95% confidence level. No relation was found between Pourcelot ratio on admission in labour or change in Pourcelot ratio during labour and Apgar score. None of the neonates showed clinical signs of perinatal hypoxia. Conclusions: Doppler velocimetry of the umbilical arteries in labour as measured by the Pourcelot ratio does not contribute to the diagnosis of fetal distress in labour.en_ZA
dc.identifier.apacitationStuart, I. P. (1993). <i>An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology. Retrieved from http://hdl.handle.net/11427/27136en_ZA
dc.identifier.chicagocitationStuart, Ian Peter. <i>"An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 1993. http://hdl.handle.net/11427/27136en_ZA
dc.identifier.citationStuart, I. 1993. An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Stuart, Ian Peter AB - Introduction: An assessment of the role of Doppler ultrasound velocity waveform analysis of the fetal umbilical arteries in the diagnosis of fetal distress in labour is made from a review of the literature and clinical study. Study objectives: 1) To determine the value of screening with Doppler ultrasound in high-risk labours in the prediction of the development of indicators of fetal distress. 2) To determine whether Doppler velocimetry indices of the umbilical arteries change with the development of indicators of fetal distress in labour. Design: Repeated Doppler velocimetry in selected high risk labours. Setting: Groote Schuur Hospital, Cape Town, South Africa, a large tertiary referral centre. Subjects: Thirty six women with singleton pregnancies complicated either by gestational proteinuric hypertension or by intrauterine growth retardation or both with a normal cardiotocographic tracing at the onset of labour. Main outcome measures: 1) Acid-base status of the fetus was assessed after deli very by analysis of umbilical artery blood. 2) Apgar score was recorded at 1 and 5 minutes. 3) Neonates were carefully examined for clinical signs of perinatal hypoxia. Results: Twenty seven fetuses were followed through labour. No relation was found between umbilical artery Pourcelot ratio (resistance index) on admission in labour and umbilical artery base deficit. Six fetuses were born with an umbilical artery base deficit of more than 10 mmol 1-1. Zero change in mean Pourcelot ratio was noted in both normal and acidotic fetuses. None of the acidotic fetuses showed a change in Pourcelot ratio of more than 0.03. The study had an 80% power to detect a change in mean Pourcelot ratio of 0.07 in the normal fetuses and 0.16 in the acidotic fetuses at a 95% confidence level. No relation was found between Pourcelot ratio on admission in labour or change in Pourcelot ratio during labour and Apgar score. None of the neonates showed clinical signs of perinatal hypoxia. Conclusions: Doppler velocimetry of the umbilical arteries in labour as measured by the Pourcelot ratio does not contribute to the diagnosis of fetal distress in labour. DA - 1993 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 1993 T1 - An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour TI - An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour UR - http://hdl.handle.net/11427/27136 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/27136
dc.identifier.vancouvercitationStuart IP. An assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labour. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Obstetrics and Gynaecology, 1993 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/27136en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Obstetrics and Gynaecologyen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherFetal Distress - diagnosisen_ZA
dc.subject.otherFetal monitoringen_ZA
dc.subject.otherUltrasonography, Prenatalen_ZA
dc.subject.otherUmbilical Arteries - ultrasonographyen_ZA
dc.titleAn assessment of the role of Doppler ultrasound velocity waveform analysis of the umbilical artery in the diagnosis of fetal distress in labouren_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMSc (Med)en_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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