Journal club MCQ June 2020

Learning Objectives:

Upon completion of this activity, the participant will be better able to:

Discuss the possible implications of fetoplacental Doppler indices at the time of diagnosis of late onset FGR.
Define UVBF and the difficulties in accurately sampling it.
Integrate fetoplacental Doppler measurements into the sonographic evaluation of fetuses diagnosed with late onset FGR

Question Title

* 1. Fetal growth restriction (FGR) was defined as:

a. Estimated fetal weight (EFW) or abdominal circumference (AC) <3rd or EFW or AC <10th centile associated with UA-PI >95th centile or CPR <5th centile.

b. EFW <1550 grams at 32 weeks of gestation.

c. Estimated fetal weight (EFW) and abdominal circumference (AC) <10th or EFW or AC <10th centile associated with UA-PI >95th centile or CPR <5th centile.

Question Title

* 2. Doppler parameters in pregnancies with composite adverse perinatal outcomes (CAPO) compared with those without:

a. All parameters where similar at the time of diagnosis of late onset FGR. Z-scores of mean MCA-PI and CPR were lower in pregnancies with CAPO at 36 weeks of gestation.

b. UVBF/AC Z-score was the only parameter that differed between pregnancies with and without CAPO at the time of diagnosis of late onset IUGR.

c. At the time of diagnosis of late onset FGR, Z-scores of mean MCA-PI, UVBF/AC and CPR were lower in pregnancies with CAPO, while uterine artery PI Z-score was higher.

Question Title

* 3. Which of the following parameters is the most accurate in predicting CAPO in pregnancies complicated with late-onset FGR?:

a. A multiparametric model including CPR, uterine artery PI and UVBF .

b. Mean uterine artery PI Z-score

c. UVBF/AC Z-score

Question Title

* 4. The main limitation of this study is:

a. It only includes pregnancies complicated by late-onset IUGR.

b. It is a cross-sectional study.

c. Attending obstetricians, who were not involved in the process of diagnosis were unaware of the Doppler data except for UA-PI.

Question Title

* 5. The most prevalent adverse outcome in the study group was:

a. Neonatal admission to the special care unit.

b. Acidosis at birth (Umbilical artery PH<7.1).

c. Emergency CS for fetal distress.