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.