Correlation between prenatal velocity waveforms in the aortic isthmus and neurodevelopmental outcome between the ages of 2 and 4 years
Autor: | Annie Veilleux, Claire Infante-Rivard, Julie Gosselin, Jean-Claude Fouron, Amanda Skoll, Catherine Fouron, Claudine Amiel-Tison |
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Rok vydání: | 2001 |
Předmět: |
Male
medicine.medical_specialty Birth weight Diastole Hemodynamics Gestational Age Placental insufficiency Nervous System Umbilical Arteries Pregnancy medicine.artery Internal medicine medicine Laser-Doppler Flowmetry Birth Weight Humans Aorta Retrospective Studies Ultrasonography Neurologic Examination Fetus Fetal Growth Retardation business.industry Infant Newborn Obstetrics and Gynecology Gestational age Umbilical artery medicine.disease Surgery Child Preschool embryonic structures Cardiology Female Nervous System Diseases business Blood Flow Velocity Infant Premature |
Zdroj: | American journal of obstetrics and gynecology. 184(4) |
ISSN: | 0002-9378 |
Popis: | Objective: Experimental studies on fetal lambs have shown that during an increase in the resistance to placental flow the delivery of oxygen to the brain is preserved as long as net flow through the aortic isthmus is antegrade. Our purpose was to determine whether the same changes in aortic isthmus flow in human subjects have any impact on neurodevelopmental outcome. Study Design: Forty-four fetuses were retrospectively included in this study on the basis of an abnormal Doppler velocity in the umbilical artery. Mean gestational age at delivery was 33.0 ± 2.0 weeks and mean birth weight 1386 ± 435 g. The neurodevelopmental condition was assessed between the ages of 2 and 4 years. The developmental score was analyzed in relation to the flow patterns in the fetal aortic isthmus, which were classified as follows: group A, net isthmic flow antegrade (defined as the ratio of the systolic antegrade to the diastolic retrograde velocity integrals) (n = 39); group B, net isthmic flow retrograde (n = 5). Results: Nonoptimal neurodevelopment was observed in 19 (49%) of 39 fetuses in group A and in all 5 fetuses (100%) in group B. This difference is significant and leads to a relative risk of 2.05 (95% confidence interval, 1.49-2.83) for neurodevelopmental deficit when predominantly retrograde flow is observed in the fetal aortic isthmus before birth. Conclusion: Measuring the ratio of antegrade to retrograde velocity integrals in the aortic isthmus could help in the indirect assessment of cerebral oxygenation during placental circulatory insufficiency. (Am J Obstet Gynecol 2001;184:630-6.) |
Databáze: | OpenAIRE |
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