engleski

Fetal biophysical profile and cerebro-umbilical ratio in assessment of brain damage in growth restricted fetuses

OBJECTIVE: To examine the relationship between fetal biophysical profile (FBP), Doppler cerebro-umbilical (C/U) ratio and neonatal neurosonography in growth restricted newborns. STUDY DESIGN: This prospective study included 87 growth restricted fetuses from 28 to 42 weeks of gestation. The FBP and C/U ratio were assessed twice a week. Within 48h and on the seventh day after birth, neonatal neurosonography was performed as the outcome parameter. RESULTS: Brain damage was detected, by neurosonography, in 34 newborns with intrauterine growth restriction (IUGR). Severe periventricular echodensities (PVE) were ultrasonographically verified in eleven infants. Intraventricular or intraparenchymal hemorrhage (severe intracranial hemorrhage ICH) was detected in seven infants, and subependymal hemorrhage (SEH) in nine infants with IUGR. Porencephalic cysts, as a result of chronic intrauterine hypoxia, were found in four infants, and brain atrophy was detected in one case. Nonspecific ultrasonographic changes were observed in two newborns. The FBP and C/U ratio were statistically significantly associated with neurosonographicaly verified neonatal brain lesions (P < 0.001). CONCLUSIONS: The FBP and the C/U ratio represent the useful indicators for early detection and assessment of fetal hypoxia. They may also be parameters for the prediction of neonatal neurosonography findings in newborns with IUGR.

fetal hypoxia; intrauterine growth retardation (IUGR); fetal biophysical profile; Doppler cerebro-umbilical ratio; neonatal neurosonography

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