engleski

The doppler cerebroplacental ratio and perinatal outcome in preterm intrauterine growth restriction

Intrauterine growth restriction (IUGR) is associated with significant perinatal mortality and morbidity. Doppler velocimetry and CPR index in this prospective study appears to be a simple and useful tool to discriminate high-risk pregnancies for greatest risk of perinatal mortality and /or morbidity. The abnormal CPR almost unmistakably detected jeopardised preterm fetuses with IUGR in gestation of 35 weeks and less. Introduction Intrauterine growth restriction (IUGR) is associated with significant perinatal mortality and morbidity, and may play an important role in the initiation of hypertension and cardiovascular disease during adult life. There is strong evidence that Doppler imagining correlates with perinatal outcome in a high-risk obstetric population. One of the main challenges is to distinguish normally nourished small fetuses from fetuses with true IUGR secondary to malnutrition due to uteroplacental insufficiency. Assuming the fetus is both structurally and karyotypically normal it is generally accepted that absent end-diastolic flow in umbilical artery is due to substantial increase in fetoplacental vascular impedance. The most severe cases present before 32 weeks of gestation and are usually associated with absent or reverse end-diastolic flow velocity in umbilical artery as published by Karsdorp et al. (1) where perinatal mortality in such cases raises over 40%. Knowledge of the Doppler data, especially umbilical Doppler velocimetry, is associated with reduction in perinatal mortality rate, lowering the frequency of medical interventions such as antenatal admission, labor induction and operative interventions for fetal distress. Doppler data, which combine both umbilical and cerebral velocimetry and cerebroplacental ratio introduced by Arbeille et al. (2), improved the information on the fetal status and placental dysfunction. By measuring the flow redistribution between placenta and fetal brain, the CPR (in case of pathological pregnancies), take into account the placental disturbances due to the vascular disease at this level and the cerebral response to the hypoxia induced by placental one and cerebroplacental ratio

IUGR, AGA fetuses, CPR index

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