Meler Barrabés, EvaMazarico Gallego, EdurnePeguero Yus, AnnaGonzalez, AlbaMartinez, JuditBoada, DavidVellvé, KilianArca Díaz, GemmaGómez Roig, Ma. DoloresGratacós Solsona, EduardFigueras Retuerta, Francesc2024-02-082024-03-312023-04-011470-0328https://hdl.handle.net/2445/207339Objective: This study aims to predict perinatal death or severe sequelae in isolated small-for-gestational-age fetuses, diagnosed at a periviable gestational age, based on ultrasound and Doppler parameters at diagnosis. Design: Observational study. Setting: A tertiary perinatal centre. Population: A cohort of singleton non-malformed fetuses suspected to be small for gestational age (estimated fetal weight, EFW, <10th centile) diagnosed at 22.0-25.6 weeks of gestation. The following parameters were recorded at diagnosis: severe smallness (<3rd centile); absent or reversed end-diastolic velocity in umbilical artery; abnormal middle cerebral artery Doppler; abnormal cerebroplacental ratio; abnormal uterine artery Doppler; and absent or reversed end-diastolic velocity in the ductus venosus. Methods: Logistic regression analysis. Main outcome measures: Predictive performance of EFW and Doppler parameters for short-term adverse outcome of perinatal morbimortality and composite serious adverse outcomes (death, neurological impairment or severe bronchopulmonary dysplasia). Results: A total of 155 pregnancies were included. There were 13 (8.4%) intrauterine and 11 (7.7%) neonatal deaths. A short-term adverse perinatal outcome occurred in 40 (25.8%) pregnancies. There were 31 (20%) cases of serious adverse outcomes. For the prediction of serious adverse outcomes, the combination of absent or reversed end-diastolic velocity in the umbilical artery and impaired middle cerebral artery detected by Doppler evaluation achieved a detection rate of 87%, with a false-positive rate of 14% (accuracy 86%). Conclusion: In periviable isolated small-for-gestational-age fetuses, a Doppler evaluation of the umbilical and fetal brain circulation can accurately predict short-term adverse perinatal complications and serious adverse outcomes.9 p.application/pdfeng(c) John Wiley & Sons, 2023Creixement fetalRetard del creixement intrauteríMortalitatMalalties neonatalsMalalties de la placentaFetal growthFetal growth retardationMortalityNeonatal diseasesPlacenta Diseasesinfo:eu-repo/semantics/article7397392024-02-08info:eu-repo/semantics/openAccess9308142