Magnetic Resonance Imaging in Pregnancy with Intrauterine Growth Restriction: A Pilot Study

Autor: Irene Paternò, Giuseppe De Bernardo, Maria Gabriella Alagna, Serafina Perrone, Salvatore Francesco Carbone, Antonino Santacroce, Giuseppe Buonocore
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Disease Markers
Disease Markers, Vol 2019 (2019)
ISSN: 1875-8630
0278-0240
Popis: Objective. Intrauterine growth restriction (IUGR) is a major cause of late stillbirth, though not all compromised babies remain small or are considered growth restricted as pregnancy progresses. Fetal Magnetic Resonance Imaging (f-MRI) represents a second-line tool to study pregnancies with IUGR fetuses. The aim of our study was to evaluate the usefulness of f-MRI on predicting fetal growth and the offspring’s perinatal respiratory outcome. Design. All f-MRI performed between 2014 and 2016 in Siena were analysed. Pregnancies with IUGR (Study group (SG)) were recruited together with a control population (Control group (CG)), coupled for gestational age (GA) at the time of f-MRI (mean GA 31 wks). Neonatal information was collected. The f-MRI protocol consisted of T2w images. Six regions of interest (ROI) were placed as follows: 2 on the lung, 2 on the liver, and 2 on the amniotic fluid. The signal intensities (SI) of each ROI were measured. The SI lung to liver ratio (SI lung/liver) and SI lung to amniotic fluid ratio (SI lung/amniotic fluid) were obtained for each fetus. Each ratio was compared between SG and CG. Therefore, SG was divided into two subgroups: adequate and small for gestational age (AGA and SGA) newborns. All measurements were related to offspring’s perinatal respiratory outcome. Results. SI lung/liver was linearly related with GA at the time of f-MRI and with EFW. SI lung/amniotic fluid was significantly higher in SG than in CG (p=0,014). In contrast, among SG, lower values of SI lung/amniotic fluid were found in the SGA compared to AGA (p=0,036). The days of oxygen supply were higher in the SGA subgroup than in the AGA subgroup (p=0,028). Conclusions. SI lung/liver increases with fetal lung maturation and appears to be useful to estimate intrauterine fetal growth. SI lung/amniotic fluid seems to be a reliable predictive index to distinguish the IUGR fetuses that can recover their growth from those that were born SGA. f-MRI represents a promising frontier to predict IUGR fetus outcome, thus contributing to ameliorate the perinatal management.
Databáze: OpenAIRE
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