{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:56:53Z","timestamp":1790575013697,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate a novel bilateral, segment\u2010based umbilical artery (UA) Doppler scoring system in pregnancies complicated by early\u2010 or late\u2010onset\u00a0fetal growth restriction (FGR) and to investigate its association with adverse perinatal outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single\u2010center prospective cohort study, conducted between May 2025 and December 2025,\u00a0included singleton pregnancies diagnosed with FGR according to Delphi consensus criteria. Bilateral UA Doppler measurements were obtained from six predefined anatomical sites: the perivesical segment, the free\u2010loop segment and the placental insertion site in each UA. End\u2010diastolic flow at each site was categorized as present, absent or reversed and incorporated into a cumulative UA Doppler score (0\u201318\u2009points). Composite adverse perinatal outcome (CAPO) was defined as the occurrence of at least one of the following: neonatal hypoglycemia, need for phototherapy, neonatal sepsis, respiratory distress syndrome, need for continuous positive airway pressure, need for mechanical ventilation, 5\u2010min Apgar score &lt;\u20097 or admission to the neonatal intensive care unit (NICU). Participants were stratified by UA Doppler score (&lt;\u20093\n                      <jats:italic>vs<\/jats:italic>\n                      \u2009\u2265\u20093 points). Multivariable logistic regression analysis was used to assess the association between UA Doppler score as a continuous or dichotomized variable and CAPO, adjusting for maternal age, body mass index, parity, mode of conception, estimated fetal weight percentile and gestational age at delivery. In addition, the prevalence of individual markers of fetoplacental hemodynamic deterioration, including abnormal ductus venosus Doppler, cerebroplacental ratio &lt;\u20095\n                      <jats:sup>th<\/jats:sup>\n                      percentile, intrauterine fetal demise, fetal distress leading to delivery and 5\u2010min Apgar score &lt;\u20097, was analyzed across UA Doppler score categories (0\u20132, 3\u20135, 6\u20138, 9\u201312 and &gt;\u200912\u2009points).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 251 pregnancies with FGR were included, of which 117 were early onset (&lt;\u200932\u2009weeks' gestation) and 134 were late onset (\u2265\u200932\u2009weeks' gestation). Higher UA Doppler scores (\u2265\u20093\u2009points) were associated significantly with preterm delivery and higher rates of NICU admission and CAPO in both early\u2010 and late\u2010onset FGR. In early\u2010onset FGR, higher scores were associated additionally with lower birth weight. The UA Doppler score remained associated independently with CAPO on multivariable logistic regression analysis. A significant linear trend was observed across increasing UA Doppler score categories for the rate of CAPO and individual markers of fetoplacental hemodynamic deterioration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In pregnancies complicated by early\u2010onset or late\u2010onset FGR, a higher UA Doppler score based on a multisite bilateral scoring system is associated independently with adverse perinatal outcome. These findings support the feasibility of a segment\u2010based approach to UA Doppler assessment. Further studies are required to determine the clinical benefit and feasibility of adoption within current surveillance strategies. \u00a9 2026 International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.70319","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:48:14Z","timestamp":1787665694000},"page":"341-350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modified umbilical artery Doppler scoring system based on multisite assessment: association with perinatal outcome in early and late fetal growth restriction"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9983-2306","authenticated-orcid":false,"given":"D. D.","family":"Bulan","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6233-4207","authenticated-orcid":false,"given":"B.","family":"Bayraktar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"},{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Turgut Ozal University Malatya Training and Research Hospital  Malatya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8192-8841","authenticated-orcid":false,"given":"R.","family":"Dayanan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2437-9719","authenticated-orcid":false,"given":"M. A.","family":"Ozkan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-6887","authenticated-orcid":false,"given":"N. V.","family":"Tonyali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3924-3723","authenticated-orcid":false,"given":"Z.","family":"Seyhanli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8719-1879","authenticated-orcid":false,"given":"Z. V.","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Perinatology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.22134"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.70124"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.13702"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.12.004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20854"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.15884"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2016.10.006"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2020.1097"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)62049-3"},{"issue":"6","key":"e_1_2_6_11_1","article-title":"Fetal and umbilical Doppler ultrasound in high\u2010risk pregnancies","volume":"6","author":"Alfirevic Z","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.11.1357"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.23698"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1902"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.03.029"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.05.010"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.01.012"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2004.09.019"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27665"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000004251"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.6100.1450"},{"issue":"5","key":"e_1_2_6_22_1","first-page":"109","article-title":"Intrauterine growth retardation","volume":"21","author":"Pearce JM","year":"1985","journal-title":"Birth Defects Orig Artic Ser"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2001.800101.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016340600604757"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2003.10.459"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.70027"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.22770"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2022.12.018"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2015.06.021"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2023.05.022"}],"container-title":["Ultrasound in Obstetrics &amp; Gynecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70319","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/uog.70319","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/uog.70319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T05:37:51Z","timestamp":1790573871000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/uog.70319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,25]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/uog.70319"],"URL":"https:\/\/doi.org\/10.1002\/uog.70319","archive":["Portico"],"relation":{},"ISSN":["0960-7692","1469-0705"],"issn-type":[{"value":"0960-7692","type":"print"},{"value":"1469-0705","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,25]]},"assertion":[{"value":"2025-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}