Brain Volume and Doppler Velocimetry in Growth-Restricted, Small-for-Gestational-Age, and Appropriate-for-Gestational-Age Fetuses

Hala A. E. Wahab Abdel Latif; Hassan Mostafa Gaafar; Ghada Abdel Fattah Abdel Moety; Doaa Salah Eldin Mahmoud; Nihal Mohamed El Rifai

doi:10.1055/s-0036-1586752

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2017; 34(4): 333-339
DOI: 10.1055/s-0036-1586752

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Brain Volume and Doppler Velocimetry in Growth-Restricted, Small-for-Gestational-Age, and Appropriate-for-Gestational-Age Fetuses

Autor*innen

Hala A. E. Wahab Abdel Latif

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
Hassan Mostafa Gaafar

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
Ghada Abdel Fattah Abdel Moety

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
Doaa Salah Eldin Mahmoud

¹Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt
Nihal Mohamed El Rifai

²Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract

Objective This study aims to detect possible differences in fetal brain volumes between growth-restricted fetuses (FGR), small-for-gestational-age (SGA) fetuses with normal Doppler indices, and appropriate-for-gestational-age fetuses (AGA).

Study Design Three-dimensional measurements of fetal brain volume and umbilical artery and middle cerebral artery (MCA) pulsatility index (PI) and resistance index (RI) were made in 80 AGA fetuses, 68 SGA fetuses with normal Doppler indices, and 68 FGR with brain-sparing effect between 32 and 36 weeks of gestation.

Results MCA-PI and MCA-RI were significantly lower in FGR group compared with the other two groups (p < 0.001). Brain volume was significantly lower in SGA and FGR groups compared with AGA group (p < 0.001).

Conclusion Brain volume is significantly lower in SGA and FGR groups compared with AGA group.

Keywords

brain volume - Doppler - fetal growth restriction - small-for-gestational-age fetuses - appropriate-for-gestational-age fetuses

Volltext

Referenzen

References
1 Pau CJ, Salinas CF, López PJ, Lezcano CA, García SO, Olivé LE. Perinatal outcome and cardiac dysfunction in preterm growth-restricted neonates in relation to placental impairment severity [in Spanish]. An Pediatr (Barc) 2015;
2 Cruz-Martinez R, Figueras F, Oros D , et al. Cerebral blood perfusion and neurobehavioral performance in full-term small-for-gestational-age fetuses. Am J Obstet Gynecol 2009; 201 (5) 474.e1-474.e7
3 Lackman F, Capewell V, Gagnon R, Richardson B. Fetal umbilical cord oxygen values and birth to placental weight ratio in relation to size at birth. Am J Obstet Gynecol 2001; 185 (3) 674-682
4 Lackman F, Capewell V, Richardson B, daSilva O, Gagnon R. The risks of spontaneous preterm delivery and perinatal mortality in relation to size at birth according to fetal versus neonatal growth standards. Am J Obstet Gynecol 2001; 184 (5) 946-953
5 Soothill PW, Bobrow CS, Holmes R. Small for gestational age is not a diagnosis. Ultrasound Obstet Gynecol 1999; 13 (4) 225-228
6 Doctor BA, O'Riordan MA, Kirchner HL, Shah D, Hack M. Perinatal correlates and neonatal outcomes of small for gestational age infants born at term gestation. Am J Obstet Gynecol 2001; 185 (3) 652-659
7 Severi FM, Bocchi C, Visentin A , et al. Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol 2002; 19 (3) 225-228
8 McCowan LM, Pryor J, Harding JE. Perinatal predictors of neurodevelopmental outcome in small-for-gestational-age children at 18 months of age. Am J Obstet Gynecol 2002; 186 (5) 1069-1075
9 Padidela RN, Bhat V. Neurobehavioral assessment of appropriate for gestational and small for gestational age babies. Indian Pediatr 2003; 40 (11) 1063-1068
10 Østgård HF, Løhaugen GC, Bjuland KJ , et al. Brain morphometry and cognition in young adults born small for gestational age at term. J Pediatr 2014; 165 (5) 921-927.e1
11 Rogne T, Engstrøm AA, Jacobsen GW, Skranes J, Østgård HF, Martinussen M. Fetal growth, cognitive function, and brain volumes in childhood and adolescence. Obstet Gynecol 2015; 125 (3) 673-682
12 Tolsa CB, Zimine S, Warfield SK , et al. Early alteration of structural and functional brain development in premature infants born with intrauterine growth restriction. Pediatr Res 2004; 56 (1) 132-138
13 Feldman R, Eidelman AI. Neonatal state organization, neuromaturation, mother-infant interaction, and cognitive development in small-for-gestational-age premature infants. Pediatrics 2006; 118 (3) e869-e878
14 Makhoul IR, Soudack M, Goldstein I, Smolkin T, Tamir A, Sujov P. Sonographic biometry of the frontal lobe in normal and growth-restricted neonates. Pediatr Res 2004; 55 (5) 877-883
15 Duncan KR, Issa B, Moore R, Baker PN, Johnson IR, Gowland PA. A comparison of fetal organ measurements by echo-planar magnetic resonance imaging and ultrasound. BJOG 2005; 112 (1) 43-49
16 Figueroa-Diesel H, Hernandez-Andrade E, Acosta-Rojas R, Cabero L, Gratacos E. Doppler changes in the main fetal brain arteries at different stages of hemodynamic adaptation in severe intrauterine growth restriction. Ultrasound Obstet Gynecol 2007; 30 (3) 297-302
17 Benavides-Serralde A, Hernández-Andrade E, Fernández-Delgado J , et al. Three-dimensional sonographic calculation of the volume of intracranial structures in growth-restricted and appropriate-for-gestational age fetuses. Ultrasound Obstet Gynecol 2009; 33 (5) 530-537
18 Hadlock FP. Sonographic estimation of fetal age and weight. Radiol Clin North Am 1990; 28 (1) 39-50
19 Dubiel M, Gunnarsson GO, Gudmundsson S. Blood redistribution in the fetal brain during chronic hypoxia. Ultrasound Obstet Gynecol 2002; 20 (2) 117-121
20 Scott JA, Habas PA, Kim K , et al. Growth trajectories of the human fetal brain tissues estimated from 3D reconstructed in utero MRI. Int J Dev Neurosci 2011; 29 (5) 529-536
21 Sovio U, White IR, Dacey A, Pasupathy D, Smith GCS. Screening for fetal growth restriction with universal third trimester ultrasonography in nulliparous women in the Pregnancy Outcome Prediction (POP) study: a prospective cohort study. Lancet 2015; 386 (10008): 2089-2097
22 Hsu JC, Wu YC, Wang PH , et al. Quantitative analysis of normal fetal brain volume and flow by three-dimensional power Doppler ultrasound. J Chin Med Assoc 2013; 76 (9) 504-509
23 Raine-Fenning NJ, Campbell BK, Clewes JS, Johnson IR. The interobserver reliability of ovarian volume measurement is improved with three-dimensional ultrasound, but dependent upon technique. Ultrasound Med Biol 2003; 29 (12) 1685-1690
24 Raine-Fenning NJ, Clewes JS, Kendall NR, Bunkheila AK, Campbell BK, Johnson IR. The interobserver reliability and validity of volume calculation from three-dimensional ultrasound datasets in the in vitro setting. Ultrasound Obstet Gynecol 2003; 21 (3) 283-291
25 Savchev S, Figueras F, Sanz-Cortes M , et al. Evaluation of an optimal gestational age cut-off for the definition of early- and late-onset fetal growth restriction. Fetal Diagn Ther 2014; 36 (2) 99-105
26 Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther 2014; 36 (2) 86-98
27 O'Dwyer V, Burke G, Unterscheider J , et al. Defining the residual risk of adverse perinatal outcome in growth-restricted fetuses with normal umbilical artery blood flow. Am J Obstet Gynecol 2014; 211 (4) 420.e1-420.e5
28 Baschat AA, Weiner CP. Umbilical artery doppler screening for detection of the small fetus in need of antepartum surveillance. Am J Obstet Gynecol 2000; 182 (1 Pt 1): 154-158
29 Baschat AA. Arterial and venous Doppler in the diagnosis and management of early onset fetal growth restriction. Early Hum Dev 2005; 81 (11) 877-887
30 Habek D, Jugović D, Hodek B , et al. Fetal biophysical profile and cerebro-umbilical ratio in assessment of brain damage in growth restricted fetuses. Eur J Obstet Gynecol Reprod Biol 2004; 114 (1) 29-34
31 Vergani P, Roncaglia N, Locatelli A , et al. Antenatal predictors of neonatal outcome in fetal growth restriction with absent end-diastolic flow in the umbilical artery. Am J Obstet Gynecol 2005; 193 (3 Pt 2): 1213-1218
32 Jugović D, Tumbri J, Medić M , et al. New Doppler index for prediction of perinatal brain damage in growth-restricted and hypoxic fetuses. Ultrasound Obstet Gynecol 2007; 30 (3) 303-311
33 Lobmaier SM, Figueras F, Mercade I , et al. Angiogenic factors vs Doppler surveillance in the prediction of adverse outcome among late-pregnancy small-for- gestational-age fetuses. Ultrasound Obstet Gynecol 2014; 43 (5) 533-540
34 DeVore GR. The importance of the cerebroplacental ratio in the evaluation of fetal well-being in SGA and AGA fetuses. Am J Obstet Gynecol 2015; 213 (1) 5-15
35 Mahale N, Khanal B, Mahale A, Fernandes M, Rao P, Chavadi C. Doppler prediction of adverse perinatal outcome in intrauterine growth restriction. Int J Reprod Contracept Obstet Gynecol 2015; 4 (1) 119-130
36 Maunu J, Ekholm E, Parkkola R , et al; PIPARI Study Group. Antenatal Doppler measurements and early brain injury in very low birth weight infants. J Pediatr 2007; 150 (1) 51-56.e1