Progression of Doppler changes in early-onset small for gestational age fetuses. How frequent are the different progression sequences?

Objective: To evaluate the progression of Doppler abnormalities in early-onset fetal smallness (SGA).

Methods: A total of 948 Doppler examinations of the umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV), belonging to 405 early-onset SGA fetuses, were studied, evaluating the sequences of Doppler progression, the interval examination-labor at which Doppler became abnormal and the cumulative sum of Doppler anomalies in relation with labor proximity.

Results: The most frequent sequences were that in which only the UA pulsatility index (PI) became abnormal (42.

The vertebroplacental ratio as an alternative to the cerebroplacental ratio in the evaluation of the fetus at the end of pregnancy.

Objective: Low cerebroplacental ratio (CPR) near term has emerged as a marker of fetal adverse outcome. The aim of this study was to evaluate the predictive accuracy of an alternative ratio using the vertebral artery (VA) (vertebroplacental ratio or VPR) for acid-base status at birth.

Methods: This was a prospective cohort study of 1470 pregnancies undergoing an ultrasound assessment of the umbilical artery, middle cerebral artery and VA Doppler beyond 34 weeks' gestation within 14 days of delivery.

Doppler study of the fetal vertebral artery in small for gestational age fetuses with intrauterine growth restriction.

Objectives: The purposes of this study were to evaluate the Doppler resistive index of the fetal vertebral artery in small for gestational age (SGA) fetuses and to examine the ability of the vertebral artery resistive index in the diagnosis of intrauterine growth restriction (IUGR).

Methods: A total of 437 Doppler examinations of the vertebral and umbilical artery resistive indices were performed in 437 fetuses between 26 and 41 weeks' gestation. According to birth weight, fetuses were classified into 5 groups: 1, above the 10th percentile; 2, between the 10th and 5th percentiles; 3, between the 5th and 3rd percentiles; 4, below the 3rd percentile; and 5, below the 3rd percentile with an umbilical artery resistive index above the 95th percentile.

Outcome of fetuses with diagnosis of isolated short femur in the second half of pregnancy.

Objectives. To assess the outcome of fetuses with isolated short femur detected at 19-41 weeks and determine to what extent this incidental finding should be a cause of concern in fetuses with a normal previous follow-up. Methods.

Fetal vertebral artery Doppler reference values at 19-41 weeks of gestation.

Objectives: To establish Doppler reference values for the fetal vertebral artery resistance index (VA RI), pulsatility index (VA PI) and peak systolic velocity (VA PSV), and describe their normal ratios to the umbilical artery (UA) throughout the second and third trimester of pregnancy.

Methods: Between 19 and 41 weeks of gestation, 484 ultrasound examinations of the fetal VA and UA were performed on singleton pregnant women with uncomplicated pregnancies. The VA was examined at the anatomical point where the artery surrounds the lateral masses of the atlas between the first cervical vertebra and the occipital bone, and values were obtained for the VA RI, VA PI and VA PSV.

Doppler impedance changes at the fetal brain vessels in a pregnancy affected with a multiple combination of uteroplacental anomalies.

A fetus with a very rare five-fold combination of uteroplacental anomalies, bicornuate uterus, short cervix with cervical incompetence, multilobed placenta succenturiata, accessory cotyledon within the cervical funneling, and umbilical cord insertion into the anomalous cervical cotyledon, presented an early and marked decrease at the vertebral and middle cerebral arteries Doppler resistances. This cerebral low-impedance state, usually found before labor, and considered an adaptive mechanism developed to protect the fetus at term from labor asphyxia, was present for an unknown reason at 20 weeks. After the patient was treated with vaginal progesterone, the cervix shortening improved and markedly, at the same time, the cerebral vascular resistances increased and maintained an adequate for gestational age impedance until delivery at 34 weeks.

Bicervical normal uterus with normal vagina and anteroposterior disposition of the double cervix.

We report a very uncommon uterine anomaly consisting on a normal uterus, a double cervix with an anteroposterior disposition, and absence of vaginal septum. A 36-years-old woman with one child and absence of past reproductive disorders was examined for a routine checkup. Clinical and transvaginal ultrasound examinations showed a normal uterus with a double cervix disposed in an anteroposterior fashion with the absence of vaginal septum.