Doppler examinations in the prognosis of birth status of the newborn.
AIM OF THE STUDY: Determination of correlation between Doppler parameters in the evaluation of fetal state and biochemical and clinical determinants of birth status of the newborn. MATERIAL: 30 full-term pregnancies. METHODS: Doppler parameters were determined in maternal vessels (uterine and arcuate arteries), fetal vessels (middle cerebral arteries, renal artery and descending aorta) and in umbilical arteries and veins. Levels of uric acid, xanthine and hypoxanthine, which reflect oxygen deficiency, were assessed in amniotic fluid by means of HPLC method. Furthermore, clinical condition of a newborn (rating according to the Apgar scoring system), pH-metry and gasometry in umbilical blood were assessed. RESULTS: Significant correlation between determinants of fetal and neonatal condition and Doppler parameters were determined, that is: between uric acid concentration and blood flow in fetal cerebral arteries, between base excess, pH and blood flow in umbilical vessels, between clinical examination of birth status of the newborn and renal and arcuate arterial flow and between pO2 and S/D ratio in renal artery. CONCLUSIONS: On the basis of this correlation, the following conclusions were drawn: Doppler examinations are highly useful in the prediction of birth status of the newborn if the specific conditions and appropriate range of the examination are maintained, i.e.: 1) examination must be multivascular, 2) it should involve cerebral artery, parenchymal resistance vessels (for example renal artery), umbilical artery and vein, intramural uterine vessels (for example arcuate or spiral artery), 3) among blood flow parameters not only standard indices (S/D, RI, PI), but also arterial blood flow waves velocity, specific flow and transverse section field should be considered.