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Second and third trimester Doppler
F46Fetal cerebral and adrenal blood velocimetry in predicting hypoxia of the fetus
Author(s) -
Breborowicz G. H.,
Dubiel M.,
Marsal K.,
Gudmundsson S.
Publication year - 2000
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 - 10.1046/j.1469-0705.2000.00015-1-46.x
Subject(s) - medicine , middle cerebral artery , fetus , laser doppler velocimetry , cerebral blood flow , pregnancy , adrenal gland , velocimetry , obstetrics , cerebral arteries , cardiology , anesthesia , blood flow , ischemia , physics , biology , optics , genetics
Background Animal studies have shown that hypoxic fetuses redistribute their blood flow, giving preferential supply to the brain, heart and adrenal glands. The aim of this study was to evaluate blood velocity waveforms in the fetal middle adrenal artery and cerebral arteries in relation to the outcome of high‐risk pregnancy. Methods Middle adrenal artery and anterior, middle and posterior cerebral arteries were recorded in 102 pregnancies complicated by pregnancy induced hypertension between 27 and 41 weeks of gestation. Signs of the fetal ‘adrenal‐sparing’ were considered present when pulsatility index (PI) was below the 95% confidence interval. Signs of fetal brain‐sparing were considered present when the cerebral arterial PI were < mean −2 SD of the normals and cerebroplacental PI ratio < 1.08. The blood velocimetry results were related to perinatal outcome. Results Adrenal velocimetry was strongly associated with aDVerse perinatal outcome, being significant for all studied parameters. All perinatal mortality showed signs of adrenal sparing. Adrenal sparing, but not brain sparing, was correlated with fetal acidosis. Combining adrenal velocimetry with brain velocimetry shown worser predictive results than adrenal velocimetry itself. Conclusion Fetal adrenal sparing is more predictive of perinatal outcome in high‐risk pregnancies and might be maintained longer than the brain‐sparing sign.