Assessment of uterine artery and aortic isthmus Doppler recordings as predictors of necrotizing enterocolitis

摘要

Objective: The purpose of this study was to evaluate whether changes of uterine arteries and aortic isthmus Doppler blood flow recordings could enhance the prediction of necrotizing enterocolitis. Study Design: Doppler characteristics of the uterine artery, umbilical and middle cerebral arteries, ductus venosus, and aortic isthmus were reviewed in 123 growth-restricted fetuses who were then divided into 2 groups: with and without necrotizing enterocolitis. Results: Twelve of 123 newborn infants (9%) expressed necrotizing enterocolitis. This group showed significant association between necrotizing enterocolitis and bilateral notching on the uterine artery (83.3% vs 29.7%; P <.001), uterine artery mean resistance index (83.3% vs 36.9%; P <.002), aortic isthmus diastolic blood flow velocity integrals (Z score: 7.32 vs 3.99; P =.028), and absent or negative "a" wave on the ductus venosus (17% vs 1.8%; P =.021). With the use of logistic regression, uterine bilateral notching could predict necrotizing enterocolitis with a sensitivity of 83.3% and a specificity of 70.3%. Conclusion: More than any other variable, uterine bilateral notching should be recognized as a strong risk factor for necrotizing enterocolitis.