Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study

Background: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetus...

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Main Authors: Azam Faraji, Fereshteh Gharibpour, Niloofar Namazi, Ali Mohammad Shakiba, Maryam Kasraeian, Nasrin Asadi, Homeira Vafaei, Marjan Zare, Khadijeh Bazrafshan, Zahra Oveisi
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Language:English
Published: Shiraz University of Medical Sciences 2024-10-01
Series:Iranian Journal of Medical Sciences
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Online Access:https://ijms.sums.ac.ir/article_50169_cf26ba4acbdf0bdd6ceb4bf405c879bc.pdf
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author Azam Faraji
Fereshteh Gharibpour
Niloofar Namazi
Ali Mohammad Shakiba
Maryam Kasraeian
Nasrin Asadi
Homeira Vafaei
Marjan Zare
Khadijeh Bazrafshan
Zahra Oveisi
author_facet Azam Faraji
Fereshteh Gharibpour
Niloofar Namazi
Ali Mohammad Shakiba
Maryam Kasraeian
Nasrin Asadi
Homeira Vafaei
Marjan Zare
Khadijeh Bazrafshan
Zahra Oveisi
author_sort Azam Faraji
collection DOAJ
description Background: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses.Methods: This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher’s exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden’s Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests.Results: FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased.Conclusion: UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.
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spelling doaj-art-1e87d80d1cd94d2283ff4819a6759c3e2025-08-20T02:09:56ZengShiraz University of Medical SciencesIranian Journal of Medical Sciences0253-07161735-36882024-10-01491063264210.30476/ijms.2024.100177.323150169Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective StudyAzam Faraji0Fereshteh Gharibpour1Niloofar Namazi2Ali Mohammad Shakiba3Maryam Kasraeian4Nasrin Asadi5Homeira Vafaei6Marjan Zare7Khadijeh Bazrafshan8Zahra Oveisi9Department of Obstetrics and Gynecology, School of Medicine, Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, School of Medicine, Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranDivision of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, School of Medicine, Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, School of Medicine, Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, School of Medicine, Maternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranMaternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranMaternal-fetal medicine Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranBackground: Routine Doppler study is a common tool for early diagnosis of Fetal Growth Restriction (FGR) and Small for Gestational Age (SGA) patients. It aimed to determine the role of the Foramen Ovale Pulsatility Index (FOPI) study beside routine Doppler study among patients with FGR and SGA fetuses.Methods: This prospective study was conducted on 35 FGR, 32 SGA, and 33 Appropriate for Gestational Age (AGA) fetuses. Demographic data, amniotic fluid index, neonatal outcome, and Doppler velocimetry, including Umbilical Artery Pulsatility Index (UMAPI), Uterine Artery Pulsatility Index (UTAPI), Middle Cerebral Artery Pulsatility Index (MCAPI), Ductus Venosus Pulsatility Index (DVPI), and FOPI were documented. Kolmogorov-Smirnov normality test, one-way ANOVA, Mann-Whitney U, Kruskal-Wallis, non-parametric pairwise comparisons adjusted for Bonferroni correction, Pearson correlation test, Chi square, Fisher’s exact test, and Receiver Operating Characteristic Curve (ROC) analysis with Youden’s Index (sensitivity+specificity-1) to estimate cut-off point were used to analyze the data at significance level <0.05 for all tests.Results: FOPI cut-off points were 2.24 (sensitivity=77%, specificity=94%) and 1.15 (sensitivity=90%, specificity=20%) to predict FGR and SGA, respectively. FOPI showed a positive correlation with UMAPI and UTAPI (r=0.52 and r=0.30, P<0.001 and P=0.006, respectively), but not with MCAPI and DVPI (r=0.08 and r=0.12, P=0.50 and P=0.30, respectively). Besides, UMAPI, UTAPI, and FOPI were altered among patients with stages I and II FGR. Umbilical cord potential hydrogen (umbilical cord pH), 1- and 5-min Apgar score significantly increased by Birth weight centile; however, UMAPI, FOPI, and UTAPI significantly decreased.Conclusion: UMAPI is recommended to predict short-term neonatal morbidities and demonstrate the early or late onset FGR. Besides, FOPI is suggested as the first-line Doppler study to detect abnormal growth velocity. More studies are warranted, especially considering long-term neonatal morbidities.https://ijms.sums.ac.ir/article_50169_cf26ba4acbdf0bdd6ceb4bf405c879bc.pdfapgar scoreultrasonography, dopplerfetal growth restrictionforamen ovaleumbilical arteries
spellingShingle Azam Faraji
Fereshteh Gharibpour
Niloofar Namazi
Ali Mohammad Shakiba
Maryam Kasraeian
Nasrin Asadi
Homeira Vafaei
Marjan Zare
Khadijeh Bazrafshan
Zahra Oveisi
Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study
Iranian Journal of Medical Sciences
apgar score
ultrasonography, doppler
fetal growth restriction
foramen ovale
umbilical arteries
title Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study
title_full Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study
title_fullStr Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study
title_full_unstemmed Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study
title_short Foramen Ovale Pulsatility Index as an Early Affected Doppler Study among Abnormal Growth Fetuses: A Recent Insight for Practice Based on a Prospective Study
title_sort foramen ovale pulsatility index as an early affected doppler study among abnormal growth fetuses a recent insight for practice based on a prospective study
topic apgar score
ultrasonography, doppler
fetal growth restriction
foramen ovale
umbilical arteries
url https://ijms.sums.ac.ir/article_50169_cf26ba4acbdf0bdd6ceb4bf405c879bc.pdf
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