Correlation between Pulmonary Artery Doppler with Neonatal Outcome in Patients with Placenta Accreta Spectrum Disorders

Abstract

Objective: The purpose of this study was to correlate fetal main pulmonary artery (PA) Doppler indices with the neonatal outcome in the late preterm and early term pregnancies in placenta accreta spectrum (PAS) patients Methods: A prospective cross-sectional study was conducted on 71 patients with PAS disorders singleton pregnancies undergoing elective or emergency termination of pregnancy under general anesthesia at or after 34 weeks. A full obstetrics ultrasound scan was performed within 24 hours before delivery and after corticosteroids administration to confirm the eligibility criteria and to measure PA Doppler indices in the main PA (pulsatility index (PI), resistance index (RI), systolic to diastolic (S/D) ratio, peak systolic velocity (PSV) and acceleration to ejection time (At/Et) ratio). Results: Twenty-three neonates needed respiratory support and neonatal intensive care unit (NICU) admission. Fetuses that needed respiratory support had a significantly lower gestational age at delivery (36±1.2 versus 36.8±0.5), lower estimated fetal weight (EFW) (2770±475 versus 3096±328), lower birth weight (2782±595 versus 3152±337) and also lower Apgar score than those who did not need. None of the PA Doppler parameters correlated with the neonatal need for respiratory support. The need for respiratory support was more in the neonates who were terminated on emergency basis (39.1% versus 60.9%). The depth of placental invasion correlated with maternal morbidity. Conclusions: PA Doppler parameters do not correlate with the need for respiratory support in patient with PAS disorders.