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New Doppler index for prediction of perinatal brain damage in growth‐restricted and hypoxic fetuses
Author(s) -
Jugović D.,
Tumbri J.,
Medić M.,
Jukić M. Kušan,
Kurjak A.,
Arbeille P.,
SalihagićKadić A.
Publication year - 2007
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.4094
Subject(s) - medicine , fetus , doppler effect , index (typography) , cardiology , pregnancy , genetics , biology , physics , astronomy , world wide web , computer science
Objective To evaluate the new vascular score, hypoxia index (HI), in the prediction of sonographically detected structural brain lesions in neonates within the first week after delivery of growth‐restricted fetuses. Methods This prospective study included 29 growth‐restricted fetuses delivered between 31 and 40 gestational weeks. Doppler umbilical artery (UA) and middle cerebral artery (MCA) resistance indices (RI) were recorded at 48‐h intervals for at least 2 weeks before delivery. The cerebroumbilical ratio (C/U ratio = MCA‐RI/UA‐RI) and the HI (the sum of the daily reductions in C/U ratio, i.e. percentage below the cut‐off value of 1, over the period of observation) were calculated. After delivery, neonatal outcome was evaluated according to obstetric parameters and ultrasound examinations of the brain. Doppler indices, C/U ratio and HI, as well as neonatal clinical and biochemical parameters, were tested as potential predictors of brain lesions using the C4.5 data‐mining algorithm. Results Neonatal brain lesions were detected in 13 growth‐restricted fetuses. Of all the parameters tested by the C4.5 data‐mining algorithm, only HI was identified as a predictor of neonatal brain lesions. HI also showed better correlation with neonatal biochemical parameters, such as umbilical venous partial pressure of oxygen and umbilical venous pH, compared with the C/U ratio. Conclusions HI, which takes into account cumulative oxygen deficit, could significantly improve the prediction of a poor neurological outcome in pregnancies complicated by growth restriction and hypoxia. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.