In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Unterscheider J, Daly S, Geary MP, et al. Predictable progressive Doppler deterioration in IUGR—does it really exist? Am J Obstet Gynecol 2013;209:539.e1-7.
See related article, page 539
For a summary and analysis of this discussion, see page 589
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Why is this research question interesting?
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What was the study design?
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Were the scans standardized in any way?
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What were the results?
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What were the study’s strengths?
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Will the findings change your practice at all?
Introduction
Much research has focused on whether, over time, Doppler ultrasound can document a predictable sequence of deterioration in maternal and fetal blood vessels in intrauterine growth restriction (IUGR). This month, Journal Club members discussed a study that examined the prognostic value of interrogating multiple blood vessels rather than just the standard umbilical artery (UA) imaging. Unterscheider and colleagues accumulated 7769 data points from 1116 fetuses to determine if, in fact, a dominant pattern of vessel decline exists. They believe their findings say much about the natural course of Doppler changes in individual fetuses with IUGR and that the data can serve as a foundation for future intervention trials.
George A. Macones, MD, MSCE, Associate Editor
Introduction
Much research has focused on whether, over time, Doppler ultrasound can document a predictable sequence of deterioration in maternal and fetal blood vessels in intrauterine growth restriction (IUGR). This month, Journal Club members discussed a study that examined the prognostic value of interrogating multiple blood vessels rather than just the standard umbilical artery (UA) imaging. Unterscheider and colleagues accumulated 7769 data points from 1116 fetuses to determine if, in fact, a dominant pattern of vessel decline exists. They believe their findings say much about the natural course of Doppler changes in individual fetuses with IUGR and that the data can serve as a foundation for future intervention trials.
George A. Macones, MD, MSCE, Associate Editor
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