EP08.16: Comparison of umbilical artery pulsatility index references

Compare the prognostic accuracy of umbilical artery pulsatility index (UAPI) references for small for gestational age (SGA) and a composite of adverse neonatal outcomes (CANO). This was a secondary analysis of a study of singletons with fetal growth assessment by EFW between 26- 36 weeks. We excluded cases with chromosomal or congenital malformations and without delivery information. We included pregnancies with EFW or AC < 20th%tile and UAPI measurements. The prediction ability of UAPI > 95th%tile for each reference (Achyara [Ach], INTERGROWTH [IG], Fetal Medicine Foundation [FMF], and Parra [Par]) for SGA and CANO was determined by comparing the area under the curve of receiver operating characteristics curve (AUC). Sensitivity, specificity, and predictive values were calculated. Of the 1054 participants with complete data, 207 were included for analysis. SGA and CANO were detected in 94 (45.4%) and 50 cases (20.2%) respectively. Despite having a statistically significant prediction ability for SGA and CANO, all standards had similar and poor prediction accuracy, AUC ≤ 0.6 (see figure 1). All UAPI references had low sensitivities and high specificity for SGA and CANO (see table 1). The references studied have poor discriminatory ability for SGA and CANO. Currently, one specific UAPI reference standard cannot be recommended over another. Larger trials are needed to answer our research question. Sensitivity % Specificity % PPV % NPV % AUC (95% CI) Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.