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Titolo:
Abnormal Doppler in the middle velocimetry and blood flow volume cerebral artery in very severe intrauterine growth restriction: is the occurrence ofreversal of compensatory flow too late?
Autore:
Konje, JC; Bell, SC; Taylor, DJ;
Indirizzi:
Univ Leicester, Fetal Growth & Dev Res Grp, Leicester LE1 7RH, Leics, England Univ Leicester Leicester Leics England LE1 7RH er LE1 7RH, Leics, England
Titolo Testata:
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
fascicolo: 9, volume: 108, anno: 2001,
pagine: 973 - 979
SICI:
1470-0328(200109)108:9<973:ADITMV>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
VELOCITY WAVE-FORMS; FETAL; HYPOXEMIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Konje, JC Leicester Royal Infirm, Fetal Growth & Dev Res Grp, Dept Obstet & Gynaecol, Robert Kilpatrick Clin Sci Bldg, Leicester LE2 7LX, Leics, England Leicester Royal Infirm Robert Kilpatrick Clin Sci Bldg Leicester Leics England LE2 7LX
Citazione:
J.C. Konje et al., "Abnormal Doppler in the middle velocimetry and blood flow volume cerebral artery in very severe intrauterine growth restriction: is the occurrence ofreversal of compensatory flow too late?", BR J OBST G, 108(9), 2001, pp. 973-979

Abstract

Objectives To determine the time course of quantified volumetric flow and pulsatility index changes in the middle cerebral arteries of severe intrauterine growth restricted fetuses with absent or reversed end diastolic flow velocities (AREDFV) on umbilical artery Doppler with a view to defining thethreshold for early intervention before the onset of reversal of adaptation. Setting Fetal growth clinic of a large UK teaching hospital. Sample Seventeen severe intrauterine growth restricted (AC < third centilefor gestation and gender) fetuses with abnormal umbilical artery Doppler velocimetry and oligohydramnios (amniotic fluid index < third centile for gestation). Methods One to three daily Doppler velocimetry and quantified volume flow of the middle cerebral artery Doppler velocimetry of the umbilical arteriesand daily cardiotocography. Results Reversal of adaptation occurred in eight fetuses, four of which ended as stillbirths and four as neonatal deaths. In two of these fetuses, this had already occurred before the diagnosis of intrauterine growth restriction. In the others, the onset was rapid and difficult to predict. Volume flow in the middle cerebral arteries decreased in those fetuses exhibiting reversal of adaptation but rose in the nine in which compensatory Doppler indices persisted. The decrease in volume flow occurred before the onset of reversal of adaptation in the pulsatility index. In the fetuses exhibiting reversal of adaptation, the rise in the pulsatility index was consistent over 48 hours compared with the physiological fluctuations in pulsatility index in some fetuses where the rise was only for 24 hours followed by a fall. Quantified volume flow fell in the fetuses before reversal of adaptation set-in. The umbilical artery Doppler indices fluctuated between absent and reversed end diastolic velocities within the same fetus irrespective of the changes in the middle cerebral artery Doppler indices. Conclusion Reversal of adaptation is of sudden onset and is associated with poor prognosis. Predicting its occurrence on Doppler indices is difficultas the changes may be very rapid. However, volume flow changes appear to be slower and of earlier onset than the pulsatility index changes. This may therefore be a more useful tool in predicting imminent reversal of adaptation and therefore early delivery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 17:46:02