Subjects-
This was a prospective observational cohort study, in which women who
attended the MFM clinics at a single tertiary center, were enrolled
during an 18 months period. The study group included women with
pregnancies complicated by isolated placenta-mediated IUGR. IUGR was
defined as estimated fetal weight below the 10thpercentile using population-based growth curves for singletons
accompanied by an abnormal umbilical artery Doppler flow, defined as
pulsatility index above the 95th percentile or
absence/ reverse of end- diastolic velocity 19. The
control group included women with uncomplicated pregnancies with
appropriate for gestational age (AGA) fetus matched to the study group
by gestational age at testing. Exclusion criteria for both groups
included hypertensive diseases of pregnancy, chronic hypertension, renal
disease, diabetes mellitus, smoking, body mass index >30
kg/m2 , aspirin treatment and betamethasone
administration within a week prior to the EndoPAT test. Patients with
fetal anomalies or genetic abnormalities were also excluded. The
abnormal umbilical artery Doppler flow and lack of fetal anomalies and
genetic abnormalities indicated that placental insufficiency was most
likely the underlying cause of IUGR.
The study was approved by the institutional review board of Sheba
medical center. All women gave informed written consent before entering
the study.