Hematological indices at birth in relation to arterial and venous Doppler in small‐for‐gestational‐age fetuses

Abstract

OBJECTIVE: To correlate Doppler results with hematological indices at birth in small-for-gestational-age (SGA) fetuses. DESIGN: Prospective study. SETTING: Tertiary teaching hospital, Sao Paulo, Brazil. Population. One hundred singleton pregnancies with SGA fetuses of > 27 weeks gestational age. METHODS: All women had Doppler velocimetry of the umbilical arteries, middle cerebral artery, and ductus venosus within < 72 hours prior to delivery. After birth, umbilical artery blood was collected for hematological analysis. MAIN OUTCOME MEASURES: The association between fetal Doppler velocimetry pulsatility index (PI) and some hematological indices. RESULTS: Umbilical artery PI showed a positive correlation with nucleated red blood cell count in the umbilical cord (r = 0.46; p < 0.01), and a negative correlation with platelet count (r = -0.53; p < 0.01) and white blood cell count (r = -0.42; p < 0.01). Middle cerebral artery PI was positively correlated with platelet count (r = 0.43; p < 0.01) and white blood cell count (r = 0.38; p < 0.01), and was negatively correlated with nucleated red blood cell count (r = -0.39; p < 0.01). The ductus venosus pulsatility index showed a positive correlation with nucleated red blood cell count (r = 0.36; p < 0.01), and a negative correlation with platelet count (r = -0.37; p < 0.01) and white blood cell count (r = -0.26; p < 0.01). CONCLUSION: A significant positive or negative correlation between nucleated red blood cell, platelet and white blood cell counts, and Doppler indices suggests an association between placental insufficiency and the fetal hematological response.