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https://www.readbyqxmd.com/read/29447050/added-value-of-cerebro-placental-ratio-and-uterine-artery-doppler-at-routine-third-trimester-screening-as-a-predictor-of-sga-and-fgr-in-nonselected-pregnancies
#1
M Rial-Crestelo, R J Martinez-Portilla, A Cancemi, J Caradeux, L Fernandez, A Peguero, E Gratacos, Francesc Figueras
OBJECTIVES: To determine the added value of cerebroplacental ratio (CPR) and uterine Doppler velocimetry at third trimester scan in an unselected obstetric population to predict smallness and growth restriction. METHODS: We constructed a prospective cohort study of women with singleton pregnancies attended for routine third trimester screening (32 +0 -34 +6 weeks). Fetal biometry and fetal-maternal Doppler ultrasound examinations were performed by certified sonographers...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29422212/diagnosis-and-surveillance-of-late-onset-fetal-growth-restriction
#2
REVIEW
Francesc Figueras, Javier Caradeux, Fatima Crispi, Elisenda Eixarch, Anna Peguero, Eduard Gratacos
By consensus, late fetal growth restriction is that diagnosed >32 weeks. This condition is mildly associated with a higher risk of perinatal hypoxic events and suboptimal neurodevelopment. Histologically, it is characterized by the presence of uteroplacental vascular lesions (especially infarcts), although the incidence of such lesions is lower than in preterm fetal growth restriction. Screening procedures for fetal growth restriction need to identify small babies and then differentiate between those who are healthy and those who are pathologically small...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29418032/birth-weight-differences-at-term-are-explained-by-placental-dysfunction-but-not-by-maternal-ethnicity
#3
José Morales-Roselló, Tiran Dias, Asma Khalil, Victoria Fornes-Ferrer, Ricardo Ciammella, Laura Gimenez Roca, Alfredo Perales-Marín, Basky Thilaganathan
OBJECTIVE: The main aim of this study was to investigate the influence of ethnicity, fetal gender and placental dysfunction on birth weight (BW) in term fetuses of South Asian and Caucasian origin. METHODS: This was a retrospective study of 627 term pregnancies assessed in two public tertiary hospitals in Spain and Sri Lanka. All fetuses underwent a scan and Doppler examination within two weeks of delivery. The influences of fetal gender, ethnicity, gestational age (GA) at delivery, cerebroplacental ratio (CPR), maternal age, height, weight and parity on BW were evaluated by multivariable regression analysis...
February 8, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29410542/utility-of-prenatal-doppler-ultrasound-to-predict-neonatal-impaired-cerebral-autoregulation
#4
Sruthi R Polavarapu, Garrett D Fitzgerald, Stephen Contag, Suma B Hoffman
OBJECTIVE: Determine if abnormal prenatal Doppler ultrasound indices are predictive of postnatal impaired cerebral autoregulation. STUDY DESIGN: Prospective cohort study of 46 subjects, 240-296 weeks' gestation. Utilizing near-infrared spectroscopy and receiver-operating characteristic analysis, impaired cerebral autoregulation was defined as >16.5% time spent in a dysregulated state within 96 h of life. Normal and abnormal Doppler indices were compared for perinatal outcomes...
February 6, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29400112/risk-of-neonatal-care-unit-admission-in-small-for-gestational-age-fetuses-at-term-a-prediction-model-and-internal-validation
#5
Erkan Kalafat, Jose Morales-Rosello, Basky Thilaganathan, Jasreen Dhother, Asma Khalil
OBJECTIVE: Small for gestational age (SGA) fetuses are at increased risk of admission to the neonatal unit, even at term. We aimed to develop and validate a predictive model for the risk of prolonged neonatal unit admission in suspected SGA fetuses at term. METHODS: A single-center cohort study of singleton pregnancies with SGA fetus, defined as estimated fetal weight (EFW) less than the 10th centile, at term. The variables included known risk factors for neonatal unit admissions: maternal characteristics, EFW, abdominal circumference (AC), fetal Dopplers, gestational age (GA) at delivery, and intrapartum risk factors (meconium, pyrexia)...
February 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29295639/the-influence-of-fetal-sex-on-the-antenatal-diagnosis-of-small-for-gestational-age
#6
Grazia Volpe, Christos Ioannou, Angelo Cavallaro, Silvia Vannuccini, Sara Ruiz-Martinez, Lawrence Impey
OBJECTIVE: We evaluated the influence of fetal sex on the antenatal diagnosis and detection of small for gestational age (SGA). METHODS: The cohort consisted of unselected singleton pregnancies, undergoing routine biometry and cerebroplacental ratio (CPR) assessment at 36 weeks. Locally fitted equations for centiles and Z scores were used. "Ultrasound SGA" was defined as estimated fetal weight (EFW) < 10th centile, "SGA at birth" as birthweight (BW) < 10th centile adjusted for sex...
January 2, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29287136/cerebrovascular-hemodynamics-in-fetuses-with-congenital-heart-disease
#7
Tingting Man, Yihua He, Ying Zhao, Lin Sun, Xiaowei Liu, Shuping Ge
BACKGROUND AND OBJECTIVE: It is hypothesized that diminished cerebral vascular resistance or the "brain sparing effect" is associated with fetuses with complex congenital heart defects (CHD) and may affect their neurodevelopmental outcome. An alternative explanation is that it is related to the location, cardiac output, pressure, and resistance in left heart obstructive CHDs. We sought to determine the effects of various left and right heart obstructive defects on the cerebral and placental hemodynamics and to evaluate the utility of these variables for the assessment and prognosis of CHDs...
December 2017: Echocardiography
https://www.readbyqxmd.com/read/29231912/-cerebroplacental-ratio-cpr-and-amniotic-fluid-index-afi-as-prognostic-factors-of-terminating-pregnancy-with-cesarean-section-after-induction-of-labour
#8
Hanna Makles, Jacek R Wilczyński
HASH(0x345fe08) AIM: The aim of the study was to estimate the value of the cerebroplacental ratio (CPR) and amniotic fluid index (AFI) in pregnancies after 41 week as prognostic factors of terminating pregnancy with cesarean section after induction of labour. MATERIALS AND METHODS: The study included 130 pregnant women, including 100 women, between 41 and 42 weeks of gestation, in whom induced labour resulted in a cesarean section due to three main indications: lack of progress of labour - group I - 44 pregnant women, signs of foetal distress - group II - 32 pregnant women and lack of response to induced labour - group III - 24 pregnant women...
November 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29227010/pre-labour-screening-for-intrapartum-fetal-compromise-in-low-risk-pregnancies-at-term-cerebroplacental-ratio-and-placental-growth-factor
#9
Larissa N Bligh, Amal A Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: We sought to determine the screening performance of a low fetal cerebroplacental ratio (a marker of fetal adaptation to suboptimal growth) and maternal placental growth factor levels, respectively, both in isolation and in combination, for the detection of cesarean section for intrapartum fetal compromise and serious composite neonatal outcome. METHODS: A prospective cohort study was performed on low risk women with uncomplicated singleton pregnancies from 36 weeks to delivery...
December 11, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29190628/cord-blood-biomarkers-of-cardiac-dysfunction-and-damage-in-term-growth-restricted-fetuses-classified-by-severity-criteria
#10
Míriam Perez-Cruz, Fàtima Crispi, María Teresa Fernández, Johanna Alexandra Parra, Anna Valls, María Dolores Gomez Roig, Eduard Gratacós
OBJECTIVE: To assess cardiovascular function and damage in term small-for-gestational-age (SGA) and intrauterine growth-restricted (IUGR) fetuses by echocardiography and biomarkers in cord blood. METHODS: This was a cohort study including 60 normal fetuses and 47 term small fetuses subclassified as small for gestational age (SGA) with estimated fetal weight (EFW) between the 3rd and 9th centiles and normal fetoplacental Doppler (n = 14) or intrauterine growth restriction (IUGR, n = 33) if EFW <3rd centile or EFW <10th centile together with cerebroplacental ratio <5th and/or mean uterine artery pulsatility index >95th centile...
November 30, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29121743/profiling-of-cardiovascular-and-cerebrovascular-disease-associated-microrna-expression-in-umbilical-cord-blood-in-gestational-hypertension-preeclampsia-and-fetal-growth-restriction
#11
Ilona Hromadnikova, Katerina Kotlabova, Katarina Ivankova, Yulia Vedmetskaya, Ladislav Krofta
BACKGROUND AND METHODS: Gene expression of 29 cardiovascular and cerebrovascular disease associated microRNAs was assessed in whole umbilical cord blood, compared between groups [47 gestational hypertension (GH), 56 preeclampsia (PE), 37 fetal growth restriction (FGR) and 44 normal pregnancies] and correlated with the severity of the disease with respect to clinical signs (mild PE vs. severe PE), delivery date (before and after 34weeks of gestation), and Doppler ultrasound parameters [pulsatility index (PI) in the umbilical artery, PI in the middle cerebral artery and the cerebroplacental ratio]...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28969483/the-risk-of-preterm-birth-associated-with-a-low-cerebroplacental-ratio
#12
Ashleigh Smith, Christopher Flatley M ClinEpi, Sailesh Kumar
OBJECTIVE: This paper investigated whether a cerebroplacental ratio (CPR) < 10th centile (measured between 23 + 0-36 + 0 weeks gestation) is predictive of any preterm birth, birth within 2 weeks of the ultrasound scan or spontaneous preterm birth. METHODS: This was a retrospective cohort study of 8977 women during 2014 and 2015 at a major tertiary referral hospital. Selection criteria included women who had a nonanomalous, singleton fetus and underwent an ultrasound scan between 23 + 0-36 + 6 weeks gestation...
October 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28926826/a-low-cerebroplacental-ratio-at-20-24-weeks-of-gestation-can-predict-reduced-fetal-size-later-in-pregnancy-or-at-birth
#13
Edgar Hernandez-Andrade, Eli Maymon, Offer Erez, Homam Saker, Suchaya Luewan, Maynor Garcia, Hyunyoung Ahn, Adi L Tarca, Bogdan Done, Steven J Korzeniewski, Sonia S Hassan, Roberto Romero
AIM: To determine whether Doppler evaluation at 20-24 weeks of gestation can predict reduced fetal size later in pregnancy or at birth. METHODS: Fetal biometry and Doppler velocimetry were performed in 2,986 women with a singleton pregnancy at 20-24 weeks of gestation. Predictive performances of the umbilical artery pulsatility index (UA-PI) or the mean uterine artery pulsatility index (UtA-PI) >95th percentile, middle cerebral artery pulsatility index, or cerebroplacental ratio (CPR) <5th percentile for early small for gestational age (SGA; <34 weeks of gestation), late SGA (≥34 weeks of gestation), or SGA at birth (birthweight <10th percentile) were analyzed...
September 20, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28892225/expectant-management-of-pregnancies-complicated-by-fetal-growth-restriction-without-any-evidence-of-placental-dysfunction-at-term-comparison-with-routine-labor-induction
#14
Nobuhiro Hidaka, Yuka Sato, Saki Kido, Yasuyuki Fujita, Kiyoko Kato
AIM: To assess the feasibility and practicality of expectant management for pregnancies with fetal growth restriction (FGR) at term without evidence of placental dysfunction. METHODS: We reviewed the records of pregnancies with an estimated fetal weight ≤ 1.5 SD below the mean at 37 weeks of gestation. We excluded elective cesarean deliveries and pregnancies that, at 37 weeks, were complicated by oligohydramnios, decreased fetal cerebroplacental ratio, or pregnancy-related hypertensive disorders...
September 11, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28854913/reduced-growth-velocity-across-the-third-trimester-is-associated-with-placental-insufficiency-in-fetuses-born-at-a-normal-birthweight-a-prospective-cohort-study
#15
Teresa M MacDonald, Lisa Hui, Stephen Tong, Alice J Robinson, Kirsten M Dane, Anna L Middleton, Susan P Walker
BACKGROUND: While being small-for-gestational-age due to placental insufficiency is a major risk factor for stillbirth, 50% of stillbirths occur in appropriate-for-gestational-age (AGA, > 10th centile) fetuses. AGA fetuses are plausibly also at risk of stillbirth if placental insufficiency is present. Such fetuses may be expected to demonstrate declining growth trajectory across pregnancy, although they do not fall below the 10th centile before birth. We investigated whether reduced growth velocity in AGA fetuses is associated with antenatal, intrapartum and neonatal indicators of placental insufficiency...
August 31, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28816083/screening-for-adverse-perinatal-outcomes-uterine-artery-doppler-cerebroplacental-ratio-and-estimated-fetal-weight-in-low-risk-women-at-term
#16
Larissa N Bligh, Amal Alsolai, Ristan M Greer, Sailesh Kumar
OBJECTIVE: To stratify apparently low-risk pregnant women into those who are at risk of adverse perinatal outcomes. Appropriate stratification would allow targeted prenatal and intrapartum management. METHODS: This prospective, observational study included normotensive women with appropriately grown, non-anomalous, singleton pregnancies. Participants underwent fortnightly ultrasounds from 36 weeks' gestation and intrapartum and neonatal outcomes were recorded. The association between uterine artery pulsatility index (UtA-PI), the cerebroplacental ratio (CPR) and estimated fetal weight (EFW) were explored along with their screening performance for CS-IFC and CNM...
October 3, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28782171/longitudinal-growth-assessment-for-the-prediction-of-adverse-perinatal-outcome-in-sga-suspected-fetuses
#17
Javier Caradeux, Elisenda Eixarch, Edurne Mazarico, Tri Rahmat Basuki, Eduard Gratacos, Francesc Figueras
BACKGROUND: Fetal growth restriction (FGR) is associated with an increased risk of adverse perinatal outcome (APO). However, distinguishing this condition from smallness-for-gestational age remains elusive. A set of criteria has recently been proposed for such purpose, including the severity of smallness, Doppler parameters and growth velocity. OBJECTIVES: To establish whether the use of growth velocity adds to Doppler evaluation in predicting APO among SGA-suspected fetuses...
August 7, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28782146/cerebroplacental-ratio-in-reduced-fetal-movements-evidence-for-worsening-fetal-hypoxemia
#18
Julia Binder, Caitriona Monaghan, Baskaran Thilaganathan, José Morales-Roselló, Asma Khalil
OBJECTIVE: To investigate the fetal cerebroplacental ratio (CPR) in women presenting with reduced fetal movements (RFM). METHODS: This is a retrospective cohort study conducted over a 7-year period at a Fetal Medicine Unit at a tertiary referral centre. 4500 singleton pregnancies presenting with RFM after 36 weeks' gestation and 1527 control pregnancies at a similar gestation without RFM were analysed. Fetal biometry and Doppler parameters were recorded and converted into centiles and multiples of the median (MoM)...
August 7, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28746928/diagnostic-performance-of-cerebroplacental-ratio-thresholds-at-term-for-prediction-of-low-birthweight-and-adverse-intrapartum-and-neonatal-outcomes-in-a-term-low-risk-population
#19
Larissa N Bligh, Amal Al Solai, Ristan M Greer, Sailesh Kumar
OBJECTIVES: To investigate the screening performance and best threshold centile (5th vs. 10th) of the cerebroplacental ratio (CPR) in low-risk, term pregnancies to predict low birthweight and adverse intrapartum and neonatal outcomes in a term, low-risk population. METHODS: This was a blinded, prospective, cross-sectional study of low-risk singleton pregnancies at term. Women attended fortnightly from 36 weeks for CPR and estimated fetal weight assessment. Intrapartum and neonatal outcomes were recorded...
July 27, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28738721/the-clinical-value-of-maternal-and-fetal-doppler-parameters-in-low-risk-postdates-pregnancies-a-prospective-study
#20
Oshrit Lebovitz, Eran Barzilay, Shali Mazaki-Tovi, Itai Gat, Reuven Achiron, Yinon Gilboa
OBJECTIVE: The objective of this study is to determine the clinical significance of maternal and fetal ultrasound Doppler flow indices in postdates pregnancies. METHODS: This prospective study comprised 120 low-risk pregnant women beyond 40 weeks of gestation. All participants underwent Doppler assessment including of fetal middle cerebral artery (MCA), umbilical, and uterine arteries. Perinatal outcomes were recorded and evaluated for possible associations with Doppler flow values...
August 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
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