scholarly journals OC22.02: Combination of the aortic isthmus with ductus venosus improves the prediction of neurological damage in early-onset intrauterine growth restricted fetuses

2010 ◽  
Vol 36 (S1) ◽  
pp. 40-40 ◽  
Author(s):  
R. Cruz-Martinez ◽  
F. Figueras ◽  
V. Tenorio ◽  
D. V. Valsky ◽  
A. Arranz ◽  
...  
Keyword(s):  
Early Onset ◽  
Ductus Venosus ◽  
Neurological Damage ◽  
Aortic Isthmus ◽  
Intrauterine Growth

scholarly journals The usefulness of fetal Doppler evaluation in early versus late onset intrauterine growth restriction. Review of the literature.

2016 ◽  
Vol 18 (1) ◽  
pp. 103 ◽  
Author(s):  
Daniel Mureșan ◽  
Ioana Cristina Rotar ◽  
Florin Stamatian
Keyword(s):  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Pulsatility Index ◽  
Late Onset ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Intrauterine Growth ◽  
Fetal Doppler ◽  
Doppler Evaluation ◽  
Early Onset Preeclampsia

Intrauterine growth restriction (IUGR) represents a serious condition that can lead to increased perinatal morbidity, mortality and postnatal impaired neurodevelopment. There are two distinct phenotypes of IUGR: early onset and late onset IUGR with different onset, patterns of evolution and fetal Doppler profile. In early onset preeclampsia the main Doppler modifications are at the level of umbilical artery, with progressive augmentation of the pulsatility index to absent or reverse end diastolic flow. The modifications of the cerebral, cardiac and ductus venosus circulation are generally present, but with different sequences. The late onset IUGR is determined by third trimester placental insufficiency that entails fetal hypoxia. The cerebro-placental ratio (CPR) and the pulsatility index of the middle cerebral artery (PI MCA) seems to be the main markers for both diagnosis and obstetrical management while umbilical Doppler PI is frequently normal. Also the sequence of Doppler alterations is neither specific nor complete. New protocols for the diagnosis and management of late onset IUGR need to be implemented.

scholarly journals Correlation of Doppler assessment of fetal aortic isthmus with perinatal outcome in intrauterine growth restriction

2018 ◽  
Vol 7 (9) ◽  
pp. 3780
Author(s):  
Bhoomika Tantuway ◽  
Y. M. Mala ◽  
Anju Garg ◽  
Reva Tripathi
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Ductus Venosus ◽  
Additional Parameter ◽  
Intrauterine Death ◽  
Aortic Isthmus ◽  
Diastolic Velocity

Background: The objective of the present study was to find out association between aortic isthmus Doppler changes and perinatal outcome in growth restricted fetuses with placental insufficiency.Methods: It is a prospective case control study, cases were 43 pregnant women with fetal growth restriction (FGR) with abnormal umbilical artery (UA) Doppler while 43 pregnant women with FGR but normal UA doppler, matched with period of gestation were taken as control. The direction of blood flow in aortic isthmus studied which may be antegrade, absent or retrograde and correlation between qualitative parameters of umbilical artery, aortic isthmus and ductus venosus were studied. Quantitative parameters, PI and RI were also calculated. Patients were managed as per hospital protocols. Perinatal outcome and any adverse event e.g. stillbirth, neonatal death, respiratory distress syndrome, intensive care unit stay >14 days etc. was noted.Results: The number of intrauterine death (IUD) and still birth was increased in women with absent and retrograde flow in aortic isthmus, 66.7% and 71.4% respectively (p value <0.001). Retrograde blood flow in the aortic isthmus is consistently associated with absent or reverse end diastolic velocity in umbilical artery and ductus venosus.Conclusions: Doppler of aortic isthmus is an additional parameter to assess severity of FGR. It plays an important role in termination of preterm FGR fetuses.

Risk of Perinatal Death in Early-Onset Intrauterine Growth Restriction according to Gestational Age and Cardiovascular Doppler Indices: A Multicenter Study

2012 ◽  
Vol 32 (1-2) ◽  
pp. 116-122 ◽  
Author(s):  
Mónica Cruz-Lemini ◽  
Fàtima Crispi ◽  
Tim Van Mieghem ◽  
Daniel Pedraza ◽  
Rogelio Cruz-Martínez ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Gestational Age ◽  
Early Onset ◽  
Intrauterine Growth Restriction ◽  
Perinatal Death ◽  
Growth Restriction ◽  
Intrauterine Growth ◽  
Doppler Indices

scholarly journals Fetal Growth Restriction – Diagnostic Work-up, Management and Delivery

2020 ◽  
Vol 80 (10) ◽  
pp. 1016-1025 ◽  
Author(s):  
Dietmar Schlembach
Keyword(s):  
Early Onset ◽  
Late Onset ◽  
Fetal Monitoring ◽  
Later Life ◽  
Growth Restriction ◽  
Growth Potential ◽  
Ductus Venosus ◽  
Optimum Approach ◽  
Diagnostic Work ◽  
Genetically Determined

AbstractFetal or intrauterine growth restriction (FGR/IUGR) affects approximately 5 – 8% of all pregnancies and refers to a fetus not exploiting its genetically determined growth potential. Not only a major cause of perinatal morbidity and mortality, it also predisposes these fetuses to the development of chronic disorders in later life. Apart from the timely diagnosis and identification of the causes of FGR, the obstetric challenge primarily entails continued antenatal management with optimum timing of delivery. In order to minimise premature birth morbidity, intensive fetal monitoring aims to prolong the pregnancy and at the same time intervene, i.e. deliver, before the fetus is threatened or harmed. It is important to note that early-onset FGR (< 32 + 0 weeks of gestation [wks]) should be assessed differently than late-onset FGR (≥ 32 + 0 wks). In early-onset FGR progressive deterioration is reflected in abnormal venous Doppler parameters, while in late-onset FGR this manifests primarily in abnormal cerebral Doppler ultrasound. According to our current understanding, the “optimum” approach for monitoring and timing of delivery in early-onset FGR combines computerized CTG with the ductus venosus Doppler, while in late-onset FGR assessment of the cerebral Doppler parameters becomes more important.

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