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Asma Khalil, Basky Thilaganathan
Identification of the fetus at risk of adverse outcome at term is a challenge to both clinicians and researchers alike. Despite the fact that fetal growth restriction (FGR) is a known risk factor for stillbirth, at least two thirds of the stillbirth cases at term are not small for gestational age (SGA) - a commonly used proxy for FGR. However, the majority of SGA fetuses are constitutionally small babies and do not suffer from adverse perinatal outcome. The cerebroplacental ratio (CPR) is emerging as a marker of failure to reach growth potential at term...
September 23, 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
Jezid Miranda, Stefania Triunfo, Merida Rodriguez-Lopez, Mikko Sairanen, Heikki Kouru, Miguel Parra-Saavedra, Francesca Crovetto, Francesc Figueras, Fatima Crispi, Eduard Gratacos
OBJECTIVE: To explore the potential value of a third trimester combined screening for the prediction of adverse perinatal outcome (APO) in the general population and among small-for-gestational age (SGA) neonates. METHODS: Nested case-control study within a prospective cohort of 1,590 singleton gestations referred for third-trimester evaluation (32(0) -36(6) weeks of gestation). Maternal baseline characteristics, mean arterial blood pressure, fetoplacental ultrasound and circulating biochemical markers [placental growth factor (PlGF), lipocalin-2, unconjugated estriol and inhibin A] were assessed in all women who subsequently presented an APO (n = 148) and in a control group without perinatal complications (n = 902)...
October 5, 2016: Ultrasound in Obstetrics & Gynecology
Anthea Gibbons, Christopher Flatley, Sailesh Kumar
OBJECTIVE: This study aimed to assess the relationship between the cerebroplacental ratio (CPR) and intrapartum and perinatal outcomes in pregnancies complicated by gestational diabetes mellitus. METHODS: This was a retrospective cohort study of women diagnosed with gestational diabetes mellitus (GDM) birthing at the Mater Mothers' Hospital in Brisbane between 2007 and 2015. The CPR in 1089 non-anomalous singleton fetuses measured between 34 + 0 and 36 + 6 weeks gestation was compared between types of GDM treatment groups and correlated with intrapartum and perinatal outcomes...
August 22, 2016: Ultrasound in Obstetrics & Gynecology
Michael Tchirikov, Zhaxybay Sh Zhumadilov, Gauri Bapayeva, Michael Bergner, Michael Entezami
OBJECTIVE: To determine if intrauterine intraumbilical supplementation with amino acids (AA) and glucose can improve neonatal outcome of severe growth restricted human fetuses (IUGR). METHODS: Prospective pilot study of intrauterine treatment of severe IUGR fetuses [n=14, 27 weeks of gestation (range 23-31)] with cerebroplacental ratio <1, with long-term intraumbilical AA and glucose supplementation (10% of feto-placental blood volume/day) using a perinatal port system alone (n=5) or combined with hyperbaric oxygenation (n=1, HBO) vs...
August 17, 2016: Journal of Perinatal Medicine
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
José Morales-Roselló, Asma Khalil, Farida Akhoundova, Silvia Salvi, Maddalena Morlando, Janani Sivanathan, José Alberola-Rubio, David Hervas-Marín, Victoria Fornés-Ferrer, Alfredo Perales-Marín, Basky Thilaganathan
OBJECTIVE: To evaluate whether changes in the cerebroplacental Doppler and birth weight (BW) suggestive of chronic fetal hypoxemia, precede the development of late-onset placental abruption (PA) after 32 weeks. METHODS: In a multicenter retrospective study, the Doppler examinations of the fetal umbilical artery (UA) and middle cerebral artery (MCA) recorded after 32 weeks were collected in pregnancies subsequently developing PA. The BW centiles were calculated and the MCA pulsatility indices (PI), and UA PI were converted into multiples of the median (MoM)...
August 2, 2016: Journal of Maternal-fetal & Neonatal Medicine
Rehana Najam, Sarika Gupta, Shalini
OBJECTIVE: To assess the predictive value of cerebroplacental ratio (i.e., S/D ratio of middle cerebral artery to S/D ratio of Umbilical artery) in detection of perinatal outcome in high-risk pregnancies. MATERIAL AND METHOD: This retrospective study was conducted on 150 patients between 28 and 40 weeks of gestation (25 low risk and 125 high risk) who attended OPD and indoor wards of Teerthanker Mahaveer medical college and research center, Moradabad. All patients had serial color Doppler ultrasounds done after taking informed consent which was repeated at 2 weeks interval, and data were collected with regard to perinatal outcome...
August 2016: Journal of Obstetrics and Gynaecology of India
Mercedes Bellido-González, Miguel Ángel Díaz-López, Setefilla López-Criado, José Maldonado-Lozano
OBJECTIVE : To determine whether cerebroplacental ratio, an indicator of fetal cerebral redistribution (FCR), predicts adverse results for neurodevelopment in intrauterine growth restriction (IUGR) infants.   METHODS : In a cohort of 5,702 infants, 64 were IUGR born at term with FCR. Five were excluded. Of the remainder, 32 presented an abnormal cerebroplacental ratio (IUGR-A) and 27 a normal one (IUGR-B). The controls were 61 appropriate-for-gestational-age children. Cognitive and academic outcomes and the odds ratio of lower academic scores were assessed by multivariate analysis of covariance and logistic regression...
June 24, 2016: Journal of Pediatric Psychology
Terri A Levine, Fiona A Alderdice, Ruth E Grunau, Fionnuala M McAuliffe
Maternal prenatal stress is associated with preterm birth, intrauterine growth restriction, and developmental delay. However, the impact of prenatal stress on hemodynamics during pregnancy remains unclear. This systematic review was conducted in order to assess the quality of the evidence available to date regarding the relationship between prenatal stress and maternal-fetal hemodynamics. The PubMed/Medline, EMBASE, PsycINFO, Maternity and Infant Care, Trip, Cochrane Library, and CINAHL databases were searched using the search terms pregnancy; stress; fetus; blood; Doppler; ultrasound...
October 2016: Archives of Women's Mental Health
Stefania Triunfo, Fatima Crispi, Eduard Gratacos, Francesc Figueras
OBJECTIVE: To explore the predictive capacity of feto-placental Doppler performed at 37 gestational weeks in identifying smallness-for-gestational age (SGA) and adverse perinatal outcome (APO). METHODS: A prospective cohort of low risk singleton pregnancies scanned at 37 gestational weeks was constructed. At inclusion, biometry for estimated fetal weight (EFW) and feto-placental Doppler evaluation (uterine artery pulsatility index [UtA-PI], cerebroplacental ratio [CPR] and umbilical vein blood flow [UVBF] normalized by EFW) were measured...
May 31, 2016: Ultrasound in Obstetrics & Gynecology
A Ruiz, M Cruz-Lemini, N Masoller, M Sanz-Cortés, Q Ferrer, I Ribera, J M Martínez, F Crispi, S Arévalo, O Gómez, S Pérez-Hoyos, E Carreras, E Gratacós, E Llurba
OBJECTIVES: To determine the longitudinal behaviour of fetal biometries and cerebroplacental haemodynamics thoughout gestation in fetuses with congenital heart disease (CHD). METHODS: Fetal biometries and Doppler haemodynamics (uterine artery (UtA), umbilical artery (UA) and middle cerebral artery (MCA)) were serially measured in a cohort of consecutive fetuses diagnosed with CHD. Evaluations were made at various time points, from diagnosis (<25 weeks) to delivery, with at least 2 measurements per foetus and at least 2 weeks apart...
May 23, 2016: Ultrasound in Obstetrics & Gynecology
José Morales-Roselló, Asma Khalil, Amparo Alba-Redondo, Luisa Martinez-Triguero, Farida Akhoundova, Alfredo Perales-Marín, Basky Thilaganathan
OBJECTIVE: To evaluate the umbilical cord venous S100β levels in late-pregnancy fetuses with abnormal growth and cerebral redistribution. METHODS: The pulsatility index of the umbilical and middle cerebral arteries and the cerebroplacental ratio (CPR) were measured in 132 fetuses at ≥34 weeks, and the CPR was converted into multiples of the median (MoM). A blood sample from the umbilical vein was collected at birth, and the umbilical venous S100β levels were evaluated in small and non-small for gestational age (SGA) fetuses, with and without abnormal Doppler indices...
April 23, 2016: Fetal Diagnosis and Therapy
Henriette O Karlsen, Cathrine Ebbing, Svein Rasmussen, Torvid Kiserud, Synnøve L Johnsen
INTRODUCTION: Centiles of middle cerebral artery pulsatility index and cerebroplacental ratio are useful for predicting adverse perinatal outcomes. A 'conditional centile' is conditioned by a previous measurement reflecting degree of individual change over time. Here we test whether such centiles are independent predictors and whether their combination improves prediction. MATERIAL AND METHODS: This prospective longitudinal study included 220 pregnant women diagnosed with or at risk of having a small-for-gestational-age fetus...
June 2016: Acta Obstetricia et Gynecologica Scandinavica
Ahmed A Nassr, Ahmed M Abdelmagied, Sherif A M Shazly
No abstract text is available yet for this article.
April 2016: Journal of Perinatal Medicine
José Morales-Roselló, Asma Khalil
No abstract text is available yet for this article.
April 2016: Journal of Perinatal Medicine
A Khalil, S Bennet, B Thilaganathan, D Paladini, P Griffiths, J S Carvalho
OBJECTIVES: Studies have shown an association between congenital heart defects (CHDs) and postnatal brain abnormalities and neurodevelopmental delay. Recent evidence suggests that some of these brain abnormalities are present before birth. The primary aim of this study was to perform a systematic review to quantify the prevalence of prenatal brain abnormalities in fetuses with CHDs. METHODS: MEDLINE, EMBASE and The Cochrane Library were searched electronically. Reference lists within each article were hand-searched for additional reports...
September 2016: Ultrasound in Obstetrics & Gynecology
Jozien C Tanis, Danique M Schmitz, Maaike R Boelen, Lucia Casarella, Paul P van den Berg, Caterina M Bilardo, Arend F Bos
AIM: To investigate whether in fetal growth restriction (FGR) Doppler PI measurements of the fetal circulation are associated with neonatal general movements (GMs). METHOD: FGR diagnosis was based on abdominal circumference or estimated fetal weight <P10 or deflecting fetal growth. Fetal Doppler parameters of the umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) were measured maximally 1 week prior to delivery. Cerebroplacental ratio (CPR) was calculated as MCA divided by UA PI...
March 2, 2016: Ultrasound in Obstetrics & Gynecology
Alberto Borges Peixoto, Taciana Mara Rodrigues da Cunha Caldas, Raisa Oliveira Santos, Karina Souza Lopes, Wellington P Martins, Edward Araujo Júnior
OBJECTIVE: To assess the impact of gestational diabetes and hypothyroidism on the third-trimester ultrasound parameters and in adverse perinatal outcomes. METHODS: We performed a retrospective cohort study with 817 singleton pregnant women between 26w0d and 37w6d of gestation which were divided in four groups: 56 gestational diabetes mellitus (GDM), 63 hypothyroidism, 14 GDM + hypothyroidism, and 684 controls. The following ultrasound parameters were assessed: mean uterine artery pulsatility index (PI), umbilical artery PI, middle cerebral artery PI, single deepest pocket (SDP) and cerebroplacental ratio (CPR)...
November 2016: Journal of Maternal-fetal & Neonatal Medicine
Narcís Masoller, Magda Sanz-Cortés, Fàtima Crispi, Olga Gómez, Mar Bennasar, Gabriela Egaña-Ugrinovic, Núria Bargalló, Josep María Martínez, Eduard Gratacós
OBJECTIVES: We evaluated the hypothesis that in fetuses with congenital heart disease (CHD) there is a correlation between the expected pattern of in utero brain blood supply and the severity of neurodevelopmental impairment. METHODS: A total of 58 fetuses with CHD and 58 controls underwent a Doppler ultrasound and fetal MRI at 36-38 weeks. Fetuses with CHD were divided into two functional classes: class A with an expected severe reduction in oxygenated brain blood supply (left outflow tract obstruction and transposition of great vessels) and class B with theoretically near-normal or mildly impaired oxygenated brain blood supply (other CHD)...
2016: Fetal Diagnosis and Therapy
José Morales-Roselló, Asma Khalil, Sylvia Salvi, Rosemary Townsend, Yaami Premakumar, Alfredo Perales-Marín
OBJECTIVE: Our aim was to evaluate whether Doppler changes in the fetal middle cerebral (MCA) and umbilical arteries (UA) suggesting fetal hypoxemia precede the onset of spontaneous preterm birth (PTB). METHODS: We studied 2,340 appropriate-for-gestational-age singleton pregnancies that had MCA and UA pulsatility indices (PI) recorded at 28-32 weeks. Values including the cerebroplacental ratio (CPR) were converted into multiples of the median and evaluated according to both gestational age at the onset of labor and the interval between ultrasound and labor...
2016: Fetal Diagnosis and Therapy
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