{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:30:11Z","timestamp":1790555411507,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2007,12,21]],"date-time":"2007-12-21T00:00:00Z","timestamp":1198195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the characteristics and association with perinatal outcome of the aortic isthmus (AoI) circulation as assessed by Doppler imaging in preterm growth\u2010restricted fetuses with placental insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective cross\u2010sectional study. Fifty\u2010one fetuses with intrauterine growth restriction (IUGR) and either an umbilical artery (UA) pulsatility index (PI) &gt; 95<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile or a cerebroplacental ratio &lt; 5<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile were examined at 24\u201336 weeks' gestation. AoI impedance indices (PI and resistance index) and absolute velocities (peak systolic (PSV), end\u2010diastolic and time\u2010averaged maximum (TAMXV) velocities), were measured in all cases and compared with reference ranges by gestational age. Furthermore, fetuses were stratified into two groups according to the direction of the diastolic blood flow in the AoI: those with antegrade flow (<jats:italic>n<\/jats:italic> = 41) and those with retrograde flow (<jats:italic>n<\/jats:italic> = 10). Clinical surveillance was based on gestational age and Doppler assessment of the UA, middle cerebral artery and ductus venosus (DV). Adverse perinatal outcome was defined as stillbirth, neonatal death and severe morbidity (respiratory distress syndrome, bronchopulmonary dysplasia, Grade III\/IV intraventricular hemorrhage, necrotizing enterocolitis and a neonatal intensive care unit stay &gt; 14 days).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adverse perinatal outcome was significantly associated with an increased AoI\u2010PI (area under the curve 0.77; 95% CI, 0.63\u20130.92; <jats:italic>P<\/jats:italic> &lt; 0.005). A significant correlation (<jats:italic>P<\/jats:italic> &lt; 0.001) was found between retrograde blood flow in the AoI and adverse perinatal outcome, the overall perinatal mortality being higher in the retrograde group (70% vs. 4.8%, <jats:italic>P<\/jats:italic> &lt; 0.001). In 4\/5 (80%) fetuses the reversal of flow in the AoI preceded that in the DV by 24\u201348 h. AoI\u2010PSV and AoI\u2010TAMXV were &lt; 5<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile in 40\/51 (78%) and 48\/51 (94%) cases, respectively, whereas AoI\u2010PI was &gt; 95<jats:sup><jats:italic>th<\/jats:italic><\/jats:sup> centile in 21\/51 (41%) cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Retrograde flow in the AoI in growth\u2010restricted fetuses correlates strongly with adverse perinatal outcome. Absolute velocities in the AoI are decreased in growth\u2010restricted fetuses. The data suggest a potential role for Doppler imaging of the AoI in the clinical surveillance of fetuses with severe IUGR, which should be confirmed in larger prospective studies. Copyright \u00a9 2007 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.5237","type":"journal-article","created":{"date-parts":[[2007,12,21]],"date-time":"2007-12-21T13:47:18Z","timestamp":1198244838000},"page":"41-47","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["Doppler assessment of the aortic isthmus and perinatal outcome in preterm fetuses with severe intrauterine growth restriction"],"prefix":"10.1002","volume":"31","author":[{"given":"M.","family":"Del R\u00edo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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