Abstract
Objective
To evaluate the test accuracy of ductus venosus Doppler for prediction of compromise
of fetal/neonatal wellbeing.
Study design
The search strategy employed searching of electronic databases (Medline, Embase, Cochrane
library, Medion) from inception to May 2009, hand searching of journal and reference
lists, contact with experts. Two reviewers independently selected articles in which
the results of ductus venosus Doppler were associated with the occurrence of compromise
of fetal/neonatal wellbeing. There were no language restrictions applied. Data were
extracted on study characteristics, quality and results to construct 2 × 2 tables. Likelihood ratios for positive and negative test results, sensitivity, specificity
and their 95% confidence intervals were generated for the different indices and thresholds.
Results
Eighteen studies, testing 2267 fetuses met the selection criteria, all performed in
a high risk population with placental insufficiency in second/third trimester. Meta-analysis
showed moderate predictive accuracy. The best result was for the prediction of perinatal
mortality, positive likelihood ratio 4.21 (95% CI 1.98–8.96) and negative likelihood
ratio 0.43 (95% CI 0.30–0.61). For prediction of adverse perinatal outcome the results
were positive likelihood ratio 3.15 (95% CI 2.19–4.54) and negative likelihood ratio
0.49 (95% CI 0.40–0.59).
Conclusion
Abnormal ductus venosus Doppler showed moderate predictive accuracy for compromise
of fetal/neonatal wellbeing overall and perinatal mortality in high risk pregnancies
with placental insufficiency.
Keywords
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Article info
Publication history
Published online: May 11, 2010
Accepted:
April 26,
2010
Received in revised form:
March 8,
2010
Received:
October 20,
2009
Identification
Copyright
© 2010 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
