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      Clinical significance of early diastolic notch depth: uterine artery Doppler velocimetry in the third trimester.

      American Journal of Obstetrics and Gynecology
      Apgar Score, Arteries, Birth Weight, Cesarean Section, Diastole, Female, Fetal Distress, Fetal Growth Retardation, Gestational Age, Humans, Intensive Care, Neonatal, Laser-Doppler Flowmetry, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Third, ROC Curve, Reproducibility of Results, Sensitivity and Specificity, Uterus, blood supply

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          Abstract

          Our purpose was to evaluate the usefulness of early diastolic notch depth in predicting adverse perinatal outcome. Uterine artery Doppler velocimetry is widely applied in predicting pregnancy outcomes. Recent studies of uterine artery early diastolic notch have demonstrated its usefulness as a marker for fetal well-being. The early diastolic notch represents the reflected blood flow of uteroplacental circulation. This study was carried out under the hypothesis that when early diastolic notch is present evaluating its depth plays a significant role in predicting poor pregnancy outcomes. Its ability to predict adverse perinatal outcomes was evaluated in 198 pregnant women with early diastolic notch after 28 weeks' gestation. The incidence of adverse perinatal outcome (5-minute Apgar score <7, cesarean delivery because of fetal distress, admission to neonatal intensive care unit, fetal growth restriction, or perinatal death) was 90.5% when the notch index was /=0.90, the respective incidences were 72.3%, 46. 9%, and 28.1%. This study suggests that evaluating notch depth in the presence of early diastolic notch on uterine artery velocimetry during the third trimester would be a useful method for predicting adverse perinatal outcomes.

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