OBJECTIVE: Our purpose was to study the relationship between fetal cerebral circulation and neurologic outcome. STUDY DESIGN: In 117 high-risk fetuses (gestational age 25 to 33 weeks) flow velocity waveforms were recorded from the umbilical and medial cerebral arteries. The ratio between umbilical and cerebral pulsatility indexes was calculated. A ratio above a predefined tolerance limit was used as an index for the "brain-sparing" effect. Neonatal neurosonography and neurologic examination were used as outcome parameters. RESULTS: Antenatally raised ratios are associated with poor obstetric outcome (fetal death and fetal growth retardation). The incidence of intracranial hemorrhages and ischemic lesions was not different for infants with a normal or raised prenatal ratio. The incidence of neurologic abnormalities was the same for both ratio groups. CONCLUSIONS: The "brain-sparing" effect is a mechanism to prevent fetal brain hypoxia rather than a sign of impending brain damage.
OBJECTIVE: Our purpose was to study the relationship between fetal cerebral circulation and neurologic outcome. STUDY DESIGN: In 117 high-risk fetuses (gestational age 25 to 33 weeks) flow velocity waveforms were recorded from the umbilical and medial cerebral arteries. The ratio between umbilical and cerebral pulsatility indexes was calculated. A ratio above a predefined tolerance limit was used as an index for the "brain-sparing" effect. Neonatal neurosonography and neurologic examination were used as outcome parameters. RESULTS: Antenatally raised ratios are associated with poor obstetric outcome (fetal death and fetal growth retardation). The incidence of intracranial hemorrhages and ischemic lesions was not different for infants with a normal or raised prenatal ratio. The incidence of neurologic abnormalities was the same for both ratio groups. CONCLUSIONS: The "brain-sparing" effect is a mechanism to prevent fetal brain hypoxia rather than a sign of impending brain damage.
Authors: A H Schaap; H Wolf; H W Bruinse; A L den Ouden; H Smolders-de Haas; I van Ertbruggen; P E Treffers Journal: Arch Dis Child Fetal Neonatal Ed Date: 1997-09 Impact factor: 5.747
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