Successful umbilical artery doppler in twim pregnancies from 22 weeks’ gestation to term: experience from a large population study

Hdl Handle:
http://hdl.handle.net/10147/128381
Title:
Successful umbilical artery doppler in twim pregnancies from 22 weeks’ gestation to term: experience from a large population study
Other Titles:
Poster presentations fetal medicine
Authors:
Breathnach, F M; McAuliffe, F.; Carroll, S.; Geary, M.; Daly, S.; Morrison, J J; Dornan, J.; Higgins, J.; Higgins, S.; Burke, G.; Dicker, P.; Malone, F D
Citation:
Arch Dis Child Fetal Neonatal Ed 2009;94:Fa11-Fa25
Journal:
Archives of Diseases in Childhood Fetal Neonatal
Issue Date:
2009
URI:
http://hdl.handle.net/10147/128381
Additional Links:
http://fn.bmj.com/content/94/Suppl_1/Fa11.full
Item Type:
Presentation
Language:
en
Description:
Objective: To determine the success rate of accurate Doppler interrogation of the umbilical artery in twin pregnancies from 22 weeks’ gestation until term in a large population study. Methods: Following training, eight experienced research sonographers assessed umbilical artery Doppler in twin gestations participating in a large multicentre study on twin growth patterns. The success rate of acquisition of Doppler indices was analysed over time in a consecutive cohort of 300 twin pairs. Images were submitted to a central data quality assurance committee. Regression analysis was used to determine which factors affected successful acquisition of the umbilical artery waveform. Results: A total of 1681 ultrasound examinations were carried out on 300 twin pregnancies by eight research sonographers between 22 weeks’ gestation and term. 85% of pregnancies were dichorionic. Multivariate regression analysis demonstrated that successful examination of the umbilical artery was weakly dependent on sonographer experience (defined by the cumulative number of scans; odds ratios (OR) 0.978, p = 0.002) but declined with increased body mass index (OR, 0.961, p<0.0001), advancing gestation (OR, 0.902, p<0.0001) and was more challenging in the presenting fetus (OR, 0.528, p<0.001). Umbilical artery Doppler success was unaffected by oligohydramnios (OR, 0.821, p = 0.626) or by chorionicity (OR, 1.09, p = 0.289). Conclusions: This study highlights the impact of factors which could pose technical difficulties in examination of umbilical artery in twin pregnancies. As Doppler indices are increasingly being factored into critical decisions regarding the management of twin pregnancies, the accuracy of such determinations is paramount.
Keywords:
FETAL MEDICINE; MULTIPLE BIRTHS
Local subject classification:
TWIN BIRTH

Full metadata record

DC FieldValue Language
dc.contributor.authorBreathnach, F Men
dc.contributor.authorMcAuliffe, F.en
dc.contributor.authorCarroll, S.en
dc.contributor.authorGeary, M.en
dc.contributor.authorDaly, S.en
dc.contributor.authorMorrison, J Jen
dc.contributor.authorDornan, J.en
dc.contributor.authorHiggins, J.en
dc.contributor.authorHiggins, S.en
dc.contributor.authorBurke, G.en
dc.contributor.authorDicker, P.en
dc.contributor.authorMalone, F Den
dc.date.accessioned2011-04-19T15:39:41Z-
dc.date.available2011-04-19T15:39:41Z-
dc.date.issued2009-
dc.identifier.citationArch Dis Child Fetal Neonatal Ed 2009;94:Fa11-Fa25en
dc.identifier.urihttp://hdl.handle.net/10147/128381-
dc.descriptionObjective: To determine the success rate of accurate Doppler interrogation of the umbilical artery in twin pregnancies from 22 weeks’ gestation until term in a large population study. Methods: Following training, eight experienced research sonographers assessed umbilical artery Doppler in twin gestations participating in a large multicentre study on twin growth patterns. The success rate of acquisition of Doppler indices was analysed over time in a consecutive cohort of 300 twin pairs. Images were submitted to a central data quality assurance committee. Regression analysis was used to determine which factors affected successful acquisition of the umbilical artery waveform. Results: A total of 1681 ultrasound examinations were carried out on 300 twin pregnancies by eight research sonographers between 22 weeks’ gestation and term. 85% of pregnancies were dichorionic. Multivariate regression analysis demonstrated that successful examination of the umbilical artery was weakly dependent on sonographer experience (defined by the cumulative number of scans; odds ratios (OR) 0.978, p = 0.002) but declined with increased body mass index (OR, 0.961, p<0.0001), advancing gestation (OR, 0.902, p<0.0001) and was more challenging in the presenting fetus (OR, 0.528, p<0.001). Umbilical artery Doppler success was unaffected by oligohydramnios (OR, 0.821, p = 0.626) or by chorionicity (OR, 1.09, p = 0.289). Conclusions: This study highlights the impact of factors which could pose technical difficulties in examination of umbilical artery in twin pregnancies. As Doppler indices are increasingly being factored into critical decisions regarding the management of twin pregnancies, the accuracy of such determinations is paramount.en
dc.language.isoenen
dc.relation.urlhttp://fn.bmj.com/content/94/Suppl_1/Fa11.fullen
dc.subjectFETAL MEDICINEen
dc.subjectMULTIPLE BIRTHSen
dc.subject.otherTWIN BIRTHen
dc.titleSuccessful umbilical artery doppler in twim pregnancies from 22 weeks’ gestation to term: experience from a large population studyen
dc.title.alternativePoster presentations fetal medicineen
dc.typePresentationen
dc.identifier.journalArchives of Diseases in Childhood Fetal Neonatalen
dc.description.provinceLeinster-
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