Venosus Doppler Insights from the Trial of Umbilical and Fetal Flow in Europe Tiziana FRUSCA MD 1 Tullia TODROS MD 2 Christoph LEES MD 34 Caterina M BILARDO MD 5 and TRUFFLE Investigators ID: 932222
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Slide1
Outcome in early-onset Fetal Growth Restriction is best combining computerized fetal heart rate analysis with Ductus
Venosus
Doppler. Insights from the Trial of Umbilical and Fetal Flow in
Europe
Tiziana FRUSCA, MD
1*
; Tullia TODROS, MD
2*
, Christoph LEES, MD
3,4
; Caterina M. BILARDO, MD
5
;
and TRUFFLE Investigators
#
Slide2“It is not possible through analysis of the available data, rationalization and/or argument to reach a conclusion about the relative merits of using
venous Doppler, fetal heart rate
analysis, the biophysical profile or a specific combination of these tests that will satisfy and persuade the proponents of each technique.”OpinionR Romero, KD Kalache, N KadarUltrasound Obstet Gynecol 2002;19:118-21.
Timing of delivery of IUGR
fetus
:
still a critical issue
Slide3multicentric
randomized trial 26-32 weeks
TRIAL RANDOMIZINGUMBILICAL andFETALFLOW in
E
UROPE
TRUFFLE
20
centres; 512 patients with severe early onset preterm IUGR
Slide4Randomized Management Study in IUGR
TRUFFLE Group
ComputerizedCTG
Early ductus changes
Late ductus changes
All groups as safety net: computerized CTG, umbilical artery Doppler
Slide5Slide6TRUFFLE Randomized Management Study in IUGR
Computerized
CTGEarly ductus changesLate ductus changes
85%
77%
91%
84%
95%
a
82%
b
p<0.004 Percentage of evaluated surviving infants
a
P=0.09 Percentage of all infants with known outcome
b
Survival free of
neurodevelopmental
impairment
Slide7www.truffle-study.org