Abstract
Objective
1) To compare morbidity among patients with intra uterine growth restriction (IUGR) neonates with and without middle cerebral artery (MCA) centralization 2) To evaluate neonatal brain sonography among these groups.
Methods
A prospective longitudinal study was designed and fifty pregnant women with singleton fetuses with an estimated fetal weight < 10th percentile for gestational age were included. MCA PI was considered abnormal (MCA centralization or redistribution) when PI was below the 5th percentile. Neonatal cranial sonographic examination was performed in the first 72 hours of life. All patients delivered in our institution and timing of delivery was done according to the protocol used in our department. Neonatal morbidity included meconium stained amniotic fluid, low Apgar scores, umbilical cord pH, hypoxic ischemic encephalopathy, respiratory distress syndrome, polycythemia and hyperbilirubinemia. Statistical analysis included parametric and nonparametric comparison tests.
Results
Two groups were defined: thirty six patients had IUGR fetuses with normal MCA blood flow velocimetry, and fourteen patients had MCA redistribution. MCA blood flow centralization was associated with a lower birth weight (1829.9 ± 436gr vs. 2100.4 ± 401gr; p-0.02) and lower gestational age at delivery (34.9 ± 2wks vs. 36.8 ± 2wks; p-0.008). Mean neonatal hospitalization was longer in fetuses with redistribution (16.1 ± 15 days vs. 8.2 ± 10; p-0.02). The rates of induction of labor, cesarean section and neonatal morbidity did not differ between the groups. Also, no pathological findings were demonstrated on neonatal cranial sonographic examination. No intraventricular hemorrhage was found in either group.
Conclusions
1) MCA redistribution in SGA neonates is associated with preterm delivery and longer neonatal hospitalization period than those with normal MCA PI 2) Early neonatal cranial sonography is not influenced by MCA redistribution.
1) To compare morbidity among patients with intra uterine growth restriction (IUGR) neonates with and without middle cerebral artery (MCA) centralization 2) To evaluate neonatal brain sonography among these groups.
Methods
A prospective longitudinal study was designed and fifty pregnant women with singleton fetuses with an estimated fetal weight < 10th percentile for gestational age were included. MCA PI was considered abnormal (MCA centralization or redistribution) when PI was below the 5th percentile. Neonatal cranial sonographic examination was performed in the first 72 hours of life. All patients delivered in our institution and timing of delivery was done according to the protocol used in our department. Neonatal morbidity included meconium stained amniotic fluid, low Apgar scores, umbilical cord pH, hypoxic ischemic encephalopathy, respiratory distress syndrome, polycythemia and hyperbilirubinemia. Statistical analysis included parametric and nonparametric comparison tests.
Results
Two groups were defined: thirty six patients had IUGR fetuses with normal MCA blood flow velocimetry, and fourteen patients had MCA redistribution. MCA blood flow centralization was associated with a lower birth weight (1829.9 ± 436gr vs. 2100.4 ± 401gr; p-0.02) and lower gestational age at delivery (34.9 ± 2wks vs. 36.8 ± 2wks; p-0.008). Mean neonatal hospitalization was longer in fetuses with redistribution (16.1 ± 15 days vs. 8.2 ± 10; p-0.02). The rates of induction of labor, cesarean section and neonatal morbidity did not differ between the groups. Also, no pathological findings were demonstrated on neonatal cranial sonographic examination. No intraventricular hemorrhage was found in either group.
Conclusions
1) MCA redistribution in SGA neonates is associated with preterm delivery and longer neonatal hospitalization period than those with normal MCA PI 2) Early neonatal cranial sonography is not influenced by MCA redistribution.
| Original language | English |
|---|---|
| Pages (from-to) | 301 |
| Number of pages | 1 |
| Journal | Ultrasound in Obstetrics & Gynecology |
| Volume | 24 |
| DOIs | |
| State | Published - 26 Aug 2004 |