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Fetal brain sparing is strongly related to the degree of increased placental vascular impedance

  • Riffat Cheema , Mariusz Dubiel and Saemundur Gudmundsson
Published/Copyright: July 19, 2006
Journal of Perinatal Medicine
From the journal Volume 34 Issue 4

Abstract

Background: Doppler ultrasound examination has become an established method of clinical surveillance in high-risk pregnancies. Doppler indication of fetal brain sparing (BS) is an acknowledged sign of circulation redistribution during chronic hypoxia.

Objectives: To evaluate the relationship between placental vascular resistance and signs of BS in middle cerebral artery (MCA) blood flow velocity.

Methods: The MCA, uterine artery, and umbilical artery (UA) were located by color Doppler ultrasound in 103 high-risk pregnancies at risk for intrauterine fetal hypoxia. The blood velocity spectrum was analyzed for the following parameters: pulsatility index (PI) and signs of notching in the uterine arteries. Z-score was calculated for the MCA PI.

Results: Signs of BS in the MCA were correlated to increased placental vascular impedance. The degree of BS in the MCA expressed as Z-scores was correlated to increasing vascular impedance, both in the umbilical and uterine arteries, and to adverse outcome of pregnancy. The greatest deviation in MCA PI Z-scores was seen in preterm pregnancies.

Conclusion: A clear correlation exists between increasing placental vascular impedance and BS in the MCA. Preterm pregnancies express the greatest deviation from the mean MCA PI.

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Corresponding author: Saemundur Gudmundsson, MD, PhD University of Lund Department of Obstetrics and Gynecology Malmö University Hospital SE-20502 Malmö Sweden

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Published Online: 2006-07-19
Published in Print: 2006-08-01

©2006 by Walter de Gruyter Berlin New York

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  4. Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy
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  6. Protein C, protein S, and thrombomodulin in amniotic fluid. A preliminary study
  7. Timing of cord clamping revisited
  8. Intrapartum cardiotocography – the dilemma of interpretational variation
  9. Maturation of the autonomic nervous system: differences in heart rate variability in premature vs. term infants
  10. Four chamber view plus three-vessel and trachea view for a complete evaluation of the fetal heart during the second trimester
  11. Pleural fluid/serum immunoglobulin ratio is a diagnostic marker for congenital chylothorax in utero
  12. Fetal brain sparing is strongly related to the degree of increased placental vascular impedance
  13. Outcome of fetuses in women with pregestational diabetes mellitus
  14. Outcome of fetuses in women with pregestational diabetes mellitus
  15. Inhaled nitric oxide therapy might reduce the need for hyperventilation therapy in infants with persistent pulmonary hypertension of the newborn
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  17. Infective puerperal endocarditis caused by Escherichia coli
  18. Correlation between plasma and urinary caffeine levels in preterm infants
  19. Fetal ascites secondary to urinary hydrocolpos
  20. Congress Calendar
  21. Suppression of IL-2 and IFN-γ production in women with spontaneous preterm labor
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