Does an abnormal UAPI follow a predictable change over time
Research type
Research Study
Full title
A retrospective survey to determine if an abnormal umbilical artery pulsatility index (UAPI)(Which is a measurement of the degree of resistance of the blood flow pumped from the babys' heart towards the placenta) follows a predictable temporal sequence in fetuses found to have an estimated fetal weight below the 10th centile (lowest acceptable size in pregnancy )on customised growth charts.
IRAS ID
106754
Contact name
Suzanne Schlanker
Contact email
Sponsor organisation
Birmingham city university
Clinicaltrials.gov Identifier
sz21708573, BCU insurance policy number
Duration of Study in the UK
2 years, 1 months, 7 days
Research summary
Doppler ultrasound uses sound waves to detect the movement of blood in blood vessels any pregnant women (over twenty four completed weeks of pregnancy) who have been found to have a small baby after a growth scan has been performed, routinely have a doppler ultrasound performed on the babies' umbilical artery. A small proportion of these small fetuses have an abnormally high resistance of flow within these vessels. This abnormality can vary in severity with literature and text books stating that there’s a natural progressive degenerating pattern. Once an abnormal doppler is identified, then it is possible that medical interventions might improve outcomes of these babies. This is a high risk pregnancy group known to have multiple complications including a high rate of fetal morbidity and mortality ( at risk of disability or death) which can be linked directly to the severity of this blood flow.
There have been multiple studies examining the prognosis of these pregnancies/babies but clinically this change happens very infrequently. The 2008 paper by Turan states, if the doppler has not deteriorated within the first fourteen days then it is unlikely to change, appears to indicate that doppler studies performed on the umbilical artery will only be of clinical value if found to be initially significantly abnormal or rapidly degenerating in nature .Equally a normal doppler trace shouldn’t be taken as an indication good fetal condition. Management of these pregnancies is difficult with many women attending hospital on a daily basis which can be stressful for varying reasons. Both Clinicians and women would therefore benefit as we can provide information to them that if no change has happened over a certain length of time then it is unlikely to, thus reducing anxiety, diagnostic tests and consultations with medics and midwifery staff with no adverse pregnancy outcomes.REC name
Yorkshire & The Humber - Leeds East Research Ethics Committee
REC reference
15/YH/0305
Date of REC Opinion
29 Jun 2015
REC opinion
Favourable Opinion