000156569 001__ 156569
000156569 005__ 20251017144601.0
000156569 0247_ $$2doi$$a10.1002/uog.20380
000156569 0248_ $$2sideral$$a118923
000156569 037__ $$aART-2020-118923
000156569 041__ $$aeng
000156569 100__ $$aRuiz-Martinez, S.
000156569 245__ $$aClinical impact of Doppler reference charts on management of small-for-gestational-age fetuses: need for standardization
000156569 260__ $$c2020
000156569 5060_ $$aAccess copy available to the general public$$fUnrestricted
000156569 5203_ $$aObjective To assess clinical variability in the management of small-for-gestational-age (SGA) fetuses according to different published Doppler reference charts for umbilical artery (UA) and fetal middle cerebral artery (MCA) Doppler indices and cerebroplacental ratio (CPR). Methods We performed a systematic search of MEDLINE, EMBASE, CINAHL and the Web of Science databases from 1954 to 2018 for studies with the sole aim of creating fetal Doppler reference values for UA, MCA and CPR. The top cited articles for each Doppler parameter were included. Variability in Doppler values at the following clinically relevant cut-offs was assessed: UA-pulsatility index (PI) > 95(th)percentile; MCA-PI < 5(th)percentile; and CPR < 5(th)percentile. Variability was calculated for each week of gestation and expressed as the percentage difference between the highest and lowest Doppler value at the clinically relevant cut-offs. Simulation analysis was performed in a cohort of SGA fetuses (n = 617) to evaluate the impact of this variability on clinical management. Results From a total of 40 studies that met the inclusion criteria, 19 were analyzed (13 for UA-PI, 10 for MCA-PI and five for CPR). Wide discrepancies in reported Doppler reference values at clinically relevant cut-offs were found. MCA-PI showed the greatest variability, with differences of up to 51% in the 5(th)percentile value at term. Variability in the 95(th)percentile of UA-PI and the 5(th)percentile of CPR at each gestational week ranged from 21% to 41% and 15% to 33%, respectively. As expected, on simulation analysis, these differences in Doppler cut-off values were associated with significant variation in the clinical management of SGA fetuses, despite using the same protocol. Conclusions The choice of Doppler reference chart can result in significant variation in the clinical management of SGA fetuses, which may lead to suboptimal outcomes and inaccurate research conclusions. Therefore, an attempt to standardize fetal Doppler reference ranges is needed.
000156569 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000156569 590__ $$a7.299$$b2020
000156569 591__ $$aACOUSTICS$$b2 / 31 = 0.065$$c2020$$dQ1$$eT1
000156569 591__ $$aRADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING$$b10 / 133 = 0.075$$c2020$$dQ1$$eT1
000156569 591__ $$aOBSTETRICS & GYNECOLOGY$$b5 / 83 = 0.06$$c2020$$dQ1$$eT1
000156569 592__ $$a3.202$$b2020
000156569 593__ $$aMedicine (miscellaneous)$$c2020$$dQ1
000156569 593__ $$aObstetrics and Gynecology$$c2020$$dQ1
000156569 593__ $$aReproductive Medicine$$c2020$$dQ1
000156569 593__ $$aRadiology, Nuclear Medicine and Imaging$$c2020$$dQ1
000156569 593__ $$aRadiological and Ultrasound Technology$$c2020$$dQ1
000156569 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000156569 700__ $$aPapageorghiou, A.T.
000156569 700__ $$aStaines-Urias, E.
000156569 700__ $$aVillar, J.
000156569 700__ $$0(orcid)0000-0001-9129-2157$$aGonzález de Aguero, R.$$uUniversidad de Zaragoza
000156569 700__ $$0(orcid)0000-0002-8476-9161$$aOros, D.$$uUniversidad de Zaragoza
000156569 7102_ $$11013$$2645$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Obstetricia y Ginecología
000156569 773__ $$g56 (2020), 166-172$$pUltrasound obstet. gynecol.$$tULTRASOUND IN OBSTETRICS & GYNECOLOGY$$x0960-7692
000156569 8564_ $$s645769$$uhttps://zaguan.unizar.es/record/156569/files/texto_completo.pdf$$yVersión publicada
000156569 8564_ $$s2867820$$uhttps://zaguan.unizar.es/record/156569/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000156569 909CO $$ooai:zaguan.unizar.es:156569$$particulos$$pdriver
000156569 951__ $$a2025-10-17-14:14:16
000156569 980__ $$aARTICLE