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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Morris, R. K. Say, R. Robson, S. C. Kleijnen, J. Khan, K. S. |
| Description | Country affiliation: United kingdom Author Affiliation: Morris RK ( School of Clinical and Experimental Medicine, University of Birmingham, Birmingham Women's Hospital, Birmingham B15 2TG, UK. r.k.morris@bham.ac.uk) |
| Abstract | OBJECTIVE: Identification of the fetus at risk of compromise is crucial to judicious allocation of monitoring resources and use of preventative treatment with the prospect of improving perinatal outcome. The accuracy of middle cerebral artery (MCA) Doppler for prediction of the fetus at risk of compromise of wellbeing is not known. The objective of this systematic review with bivariate meta-analysis was to evaluate the accuracy of middle cerebral artery Doppler for prediction of compromise of fetal/neonatal wellbeing. STUDY DESIGN: Systematic review and bivariate meta-analysis with searches of Medline, Embase, Cochrane library, Medion (inception to October 2011), hand searching of journal and reference lists, contact with experts. Two reviewers independently selected articles in which the results of middle cerebral artery Doppler were associated with the occurrence of compromise of fetal/neonatal wellbeing. There were no language restrictions applied. RESULTS: Thirty-five studies, testing 4025 fetuses, met the selection criteria. 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. Meta-analysis showed low predictive accuracy. For prediction of adverse perinatal outcome and perinatal mortality the results were positive likelihood ratios 2.77 (1.93, 3.96) and 1.36 (1.10, 1.67) and negative likelihood ratios 0.58 (0.48, 0.69) and 0.51 (0.29, 0.89) respectively. CONCLUSION: Abnormal middle cerebral artery Doppler showed limited predictive accuracy for compromise of fetal/neonatal wellbeing. High quality primary research or individual patient data meta-analysis looking at this test in combination with other tests is required. |
| File Format | HTM / HTML |
| ISSN | 03012115 |
| Issue Number | 2 |
| Volume Number | 165 |
| e-ISSN | 18727654 |
| Journal | European Journal of Obstetrics & Gynecology and Reproductive Biology |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2012-12-01 |
| Publisher Place | Ireland |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Obstetrics Discipline Gynecology Middle Cerebral Artery Ultrasonography, Prenatal Female Fetal Growth Retardation Diagnosis Humans Infant, Newborn Infant, Small For Gestational Age Predictive Value Of Tests Pregnancy Risk Journal Article Meta-analysis Research Support, Non-u.s. Gov't Review |
| Content Type | Text |
| Resource Type | Article |
| Subject | Reproductive Medicine Obstetrics and Gynecology |
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