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Placental cerebral index

Susan Addley, Amanda Ali, Stephen Ong
BACKGROUND: Pre-eclampsia and placental causes of intrauterine growth restriction (IUGR) are part of the same spectrum of disorders. In IUGR, there is preferential shunting of blood to the fetal brain at the expense of other organs. We wanted to demonstrate that this also occurs in pre-eclampsia using three dimensional (3D) ultrasound. The 3D indices of perfusion are: flow index (FI), vascular index (VI) and vascularisation flow index (VFI) which reflect tissue vascularity and flow intensity...
January 2017: Ulster Medical Journal
Maria Ome-Kaius, Stephan Karl, Regina Alice Wangnapi, John Walpe Bolnga, Glen Mola, Jane Walker, Ivo Mueller, Holger Werner Unger, Stephen John Rogerson
BACKGROUND: Doppler velocimetry studies of umbilical artery (UA) and middle cerebral artery (MCA) flow help to determine the presence and severity of fetal growth restriction. Increased UA resistance and reduced MCA pulsatility may indicate increased placental resistance and intrafetal blood flow redistribution. Malaria causes low birth weight and fetal growth restriction, but few studies have assessed its effects on uteroplacental and fetoplacental blood flow. METHODS: Colour-pulsed Doppler ultrasound was used to assess UA and MCA flow in 396 Papua New Guinean singleton fetuses...
January 19, 2017: Malaria Journal
Tamara Stampalija, Birgit Arabin, Hans Wolf, Caterina M Bilardo, Christoph Lees
BACKGROUND: Reduced fetal middle cerebral artery Doppler impedance is associated with hypoxemia in fetal growth restriction. It remains unclear as to whether this finding could be useful in timing delivery, especially in the third trimester. In this regard there is a paucity of evidence from prospective studies. OBJECTIVES: The aim of this study was to determine whether there is an association between middle cerebral artery Doppler impedance and its ratio with the umbilical artery in relation to neonatal and 2 year infant outcome in early fetal growth restriction (26(+0)-31(+6) weeks of gestation)...
May 2017: American Journal of Obstetrics and Gynecology
Christopher Flatley, Ristan M Greer, Sailesh Kumar
OBJECTIVE: The primary aim of this study was to evaluate if the magnitude of change in the cerebro-placental ratio (CPR) after 30 weeks gestation was better predictive of adverse pregnancy outcome compared to a single measurement at 35-37 weeks. A secondary aim was to evaluate whether the utility of CPR measured at 35-37 weeks was enhanced after adjusting for the gestational change. METHODS: This was a retrospective cohort study of women who had had at least two ultrasound scans between 30-37 weeks gestation with the final scan taking place at 35-37 weeks...
November 22, 2016: Ultrasound in Obstetrics & Gynecology
Lut Geerts, Elrike Van der Merwe, Anneke Theron, Kerry Rademan
OBJECTIVE: To determine the incidence of abnormal multi-vessel Doppler values among advanced pregnancies at risk of suboptimal placentation but with a normal umbilical artery resistance index (RI), and to assess whether clinical and ultrasonography findings can identify them. METHODS: In a prospective cross-sectional study at Tygerberg Hospital, South Africa, women with high-risk pregnancies but normal umbilical artery RI after 32weeks underwent ultrasonography (fetal biometry, liquor, and placenta maturation) and Doppler assessment (uterine, umbilical, and middle cerebral arteries) between February 11 and October 21, 2013...
October 2016: International Journal of Gynaecology and Obstetrics
Alberto Borges Peixoto, Taciana Mara Rodrigues da Cunha Caldas, Tácito Augusto Godoy Silva, Mário Sérgio Silva Gomes Caetano, Wellington P Martins, Eduardo Felix Martins Santana, Edward Araujo Júnior
OBJECTIVES: The aim of the study was to investigate ultrasound and Doppler parameters in the third trimester of pregnancy as possible predictors of adverse perinatal outcome in unselected pregnancies. MATERIAL AND METHODS: We performed a retrospective cross-sectional study including unselected pregnant women be-tween 27 and 36 + 6 weeks of gestation. The following ultrasound and Doppler parameters were assessed: estimated fetal weight (EFW) [g], EFW percentile, placental maturity grade (Grannum classification), single vertical deepest pocket (SVDP) of amniotic fluid [cm], amniotic fluid index (AFI) [cm], mean uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, middle cerebral artery (MCA) PI, MCA peak systolic velocity (PSV) [cm/s], and cerebroplacental ratio (CPR)...
2016: Ginekologia Polska
Daniel Mureșan, Ioana Cristina Rotar, Florin Stamatian
Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased perinatal morbidity, mortality and postnatal impaired neurodevelopment. There are two distinct phenotypes of IUGR: early onset and late onset IUGR with different onset, patterns of evolution and fetal Doppler profile. In early onset preeclampsia the main Doppler modifications are at the level of umbilical artery, with progressive augmentation of the pulsatility index to absent or reverse end diastolic flow. The modifications of the cerebral, cardiac and ductus venosus circulation are generally present, but with different sequences...
March 2016: Medical Ultrasonography
Kedak Baltajian, Surichhya Bajracharya, Saira Salahuddin, Anders H Berg, Carl Geahchan, Julia B Wenger, Ravi Thadhani, S Ananth Karumanchi, Sarosh Rana
BACKGROUND: Alterations in circulating angiogenic factors are associated with the diagnosis of preeclampsia and correlate with adverse perinatal outcomes during the third trimester. OBJECTIVE: Analysis of the sequential levels of plasma angiogenic factors among patients admitted for evaluation of preeclampsia. STUDY DESIGN: We performed an observational study among women with singleton pregnancies admitted to Beth Israel Deaconess Medical Center, Boston, Massachusetts, for evaluation of preeclampsia at less than 37 weeks of gestation...
July 2016: American Journal of Obstetrics and Gynecology
Mirta Starčević, Maja Predojević, Dražan Butorac, Jasna Tumbri, Paško Konjevoda, Aida Salihagić Kadić
AIMS: To determine whether the brain disturbances develop in late-onset intrauterine growth restriction (IUGR) before blood flow redistribution towards the fetal brain (detected by Doppler measurements in the middle cerebral artery and umbilical artery). Further, to evaluate predictive values of Doppler arterial indices and umbilical cord blood gases and pH for early functional and/or morphological brain disturbances in late-onset IUGR. STUDY DESIGN: This cohort study included 60 singleton term pregnancies with placental insufficiency caused late-onset IUGR (IUGR occurring after 34 gestational weeks)...
February 2016: Early Human Development
Ayşe Nur Aksoy, Gonca Batmaz, Banu Dane, Suna Kabil Kucur, İlay Gözükara
OBJECTIVE: We hypothesized that maternal and fetal circulations may be affected by moderately high altitudes. Therefore, we compared the differences in maternal and fetal Doppler flow parameters in women with term pregnancy living at a moderately high altitude (1890 m in Erzurum) with those of women living at the sea level (31 m in İstanbul). MATERIAL AND METHODS: Eighty women (n=40, for each group) with full-term and singleton pregnancies underwent Doppler waveform analysis, and the pulsatility and resistance index values for the uterine, umbilical, and mid-cerebral arteries were recorded...
2015: Journal of the Turkish German Gynecological Association
Meng Yuan Zhu, Natasha Milligan, Sarah Keating, Rory Windrim, Johannes Keunen, Varsha Thakur, Annika Ohman, Sharon Portnoy, John G Sled, Edmond Kelly, Shi-Joon Yoo, Lars Gross-Wortmann, Edgar Jaeggi, Christopher K Macgowan, John C Kingdom, Mike Seed
BACKGROUND: Late-onset intrauterine growth restriction (IUGR) results from a failure of the placenta to supply adequate nutrients and oxygen to the rapidly growing late-gestation fetus. Limitations in current monitoring methods present the need for additional techniques for more accurate diagnosis of IUGR in utero. New magnetic resonance imaging (MRI) technology now provides a noninvasive technique for fetal hemodynamic assessment, which could provide additional information over conventional Doppler methods...
March 2016: American Journal of Obstetrics and Gynecology
N Valiño, G Giunta, D M Gallo, R Akolekar, K H Nicolaides
OBJECTIVE: To investigate the potential value of biophysical and biochemical markers at 35-37 weeks' gestation in the prediction of adverse perinatal outcome. METHODS: This was a screening study in 3953 singleton pregnancies at 35-37 weeks' gestation. Estimated fetal weight (EFW), uterine artery pulsatility index (UtA-PI), umbilical artery (UA)-PI, fetal middle cerebral artery (MCA)-PI, mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured...
February 2016: Ultrasound in Obstetrics & Gynecology
Yen K Bui, Lisa W Howley, Steven E Ambrose, Henry L Galan, Timothy M Crombleholme, Julia Drose, John Bokowski, Bettina F Cuneo
OBJECTIVES: "Heart sparing" refers to prominent antegrade fetal coronary artery (CA) blood flow readily visualized by color Doppler and is a harbinger of poor outcome in growth restricted fetus, but little is known of the features and presentation of heart sparing in normally grown fetuses. Our objective was to describe heart sparing effects in normally grown fetuses, and compare the presentation and outcome of heart sparing between fetuses with growth restriction and those who were normally grown...
2016: Journal of Maternal-fetal & Neonatal Medicine
Philipp Wagner, Jiri Sonek, Markus Hoopmann, Harald Abele, Sara Brucker, Karl Oliver Kagan
OBJECTIVE: To examine the umbilical arterial Doppler flow patterns in late third-trimester fetuses with trisomy 21. METHODS: This is a retrospective study on fetuses with trisomy 21 that were evaluated after 33 weeks' gestation at the Department of Obstetrics and Gynaecology of the University of Tuebingen, Germany. The umbilical and the middle cerebral artery (UA and ACM) pulsatility index (PI) measurements and the abdominal circumference were transformed into z-values...
2016: Fetal Diagnosis and Therapy
Johanes C Mose
Pre-eclampsia is associated with significant maternal and fetal morbidity and mortality worldwide. Pregnancy complicated by preeclampsia and/or by fetal growth restriction are reported to have inadequate maternal vascular responses to placentation. This defective vascular response was due to the failure of second wave of endovascular trophoblast migration leading to both a reduced amount and depth of trophoblast invasion of myometrium followed by the development of placental hypoxia and ischemia that can be measured biophysically by means of Doppler Ultrasound...
July 2014: Pregnancy Hypertension
N Valiño, G Giunta, D M Gallo, R Akolekar, K H Nicolaides
OBJECTIVE: To investigate the potential value of biophysical and biochemical markers at 30-34 weeks' gestation in the prediction of adverse perinatal outcome. METHODS: This was a screening study in 8268 singleton pregnancies at 30-34 weeks' gestation. Estimated fetal weight (EFW), uterine artery (UtA) pulsatility index (PI), umbilical artery (UA) PI, fetal middle cerebral artery (MCA) PI, mean arterial pressure (MAP), serum placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured...
February 2016: Ultrasound in Obstetrics & Gynecology
N Masoller, M Sanz-CortéS, F Crispi, O Gómez, M Bennasar, G Egaña-Ugrinovic, N Bargalló, J M Martínez, E Gratacós
OBJECTIVES: Fetuses with congenital heart disease (CHD) show evidence of abnormal brain development before birth, which is thought to contribute to adverse neurodevelopment during childhood. Our aim was to evaluate whether brain development in late pregnancy can be predicted by fetal brain Doppler, head biometry and the clinical form of CHD at the time of diagnosis. METHODS: This was a prospective cohort study including 58 fetuses with CHD, diagnosed at 20-24 weeks' gestation, and 58 normal control fetuses...
January 2016: Ultrasound in Obstetrics & Gynecology
Elani Streja, Jessica E Miller, Chunsen Wu, Bodil H Bech, Lars Henning Pedersen, Diana E Schendel, Peter Uldall, Jørn Olsen
OBJECTIVE: To investigate the association between proportionality of fetal and placental growth measured at birth and the risk for congenital cerebral palsy (CP). STUDY DESIGN: We identified all live-born singletons born in Denmark between 1995 and 2003 and followed them from 1 year of age until December 31st, 2008. Information on four indices of fetal growth: ponderal index, head circumference/ abdominal circumference ratio, cephalization index and birth weight/ placenta weight ratio was collected...
2015: PloS One
Mariane de Fátima Y Maeda, Roseli M Y Nomura, Juliana I Niigaki, Rossana P V Francisco, Marcelo Zugaib
OBJECTIVE: To evaluate the reliability of fetal heart rate (FHR) parameters analyzed by computerized cardiotocography (cCTG) in predicting myocardial damage in pregnancies with placental insufficiency. STUDY DESIGN: We evaluated 38 patients with placental insufficiency detected before 34 weeks of gestation. All patients underwent 30 min of cCTG (Sonicaid Fetal Care, version 2.2) and Doppler of umbilical artery, middle cerebral artery, and ductus venosus. Umbilical vein blood samples were collected at birth to determine fetal cardiac Troponin T, and a ≥0...
July 2015: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Amir Mor, Yael Fuchs, Kathleen Zafra, Shoshana Haberman, Reshef Tal
Gestational diabetes insipidus (GDI) is a rare, self-limited complication of pregnancy. As it is related to excess placental vasopressinase enzyme activity, which is metabolized in the liver, GDI is more common in pregnancies complicated by conditions associated with liver dysfunction. We present a case of a 41-year-old woman at 38 weeks' gestation who presented with pre-eclampsia with severe features, including impaired liver function and renal insufficiency. Following cesarean section she was diagnosed with GDI, which was further complicated by cerebral vasoconstriction as demonstrated by magnetic resonance angiography...
August 2015: Journal of Obstetrics and Gynaecology Research
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