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Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study

Introduction: Late-onset intrauterine fetal growth restriction (IUGR) is a common pregnancy complication diagnosed in 5–10% of pregnant women worldwide. Under the impact of hypoxia, the fetus develops a protective mechanism of adaptive changes occurring in the cerebral circulation (“brain-sparing ef...

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Autores principales: Norvilaitė, Kristina, Ramašauskaitė, Diana, Bartkevičienė, Daiva, Šliachtenko, Aleksandra, Kurmanavičius, Juozas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821295/
https://www.ncbi.nlm.nih.gov/pubmed/36614891
http://dx.doi.org/10.3390/jcm12010082
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author Norvilaitė, Kristina
Ramašauskaitė, Diana
Bartkevičienė, Daiva
Šliachtenko, Aleksandra
Kurmanavičius, Juozas
author_facet Norvilaitė, Kristina
Ramašauskaitė, Diana
Bartkevičienė, Daiva
Šliachtenko, Aleksandra
Kurmanavičius, Juozas
author_sort Norvilaitė, Kristina
collection PubMed
description Introduction: Late-onset intrauterine fetal growth restriction (IUGR) is a common pregnancy complication diagnosed in 5–10% of pregnant women worldwide. Under the impact of hypoxia, the fetus develops a protective mechanism of adaptive changes occurring in the cerebral circulation (“brain-sparing effect”). Materials and methods: We conducted detailed longitudinal Doppler examinations and the monitoring of the fetal condition in 53 IUGR fetuses. Doppler measurements of the pulsatility index in the fetal tibial (TA-PI), umbilical (UA-PI), and middle cerebral arteries (MCA-PI) were performed, and the cerebral placental ratio (CPR) was determined on a weekly basis from the 33rd week to the birth. Results: The longitudinal analysis showed a significant increase in the TA-PI. The UA showed a plateau, but no increase was detected near term. The MCA-PI and CPR showed a progressive decrease in values from inclusion to delivery. Our findings indicate that the increase in the TA-PI was the first sign of the aggravating state of the fetus with the changes registered from the 35th week. The parameters of the UA-PI did not show significant changes, while the MCA and CPR became abnormal later from the 37th week. Conclusions: These observations can serve towards the development of guidelines for detecting the deteriorating signs and intervention timing in IUGR during late pregnancies.
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spelling pubmed-98212952023-01-07 Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study Norvilaitė, Kristina Ramašauskaitė, Diana Bartkevičienė, Daiva Šliachtenko, Aleksandra Kurmanavičius, Juozas J Clin Med Article Introduction: Late-onset intrauterine fetal growth restriction (IUGR) is a common pregnancy complication diagnosed in 5–10% of pregnant women worldwide. Under the impact of hypoxia, the fetus develops a protective mechanism of adaptive changes occurring in the cerebral circulation (“brain-sparing effect”). Materials and methods: We conducted detailed longitudinal Doppler examinations and the monitoring of the fetal condition in 53 IUGR fetuses. Doppler measurements of the pulsatility index in the fetal tibial (TA-PI), umbilical (UA-PI), and middle cerebral arteries (MCA-PI) were performed, and the cerebral placental ratio (CPR) was determined on a weekly basis from the 33rd week to the birth. Results: The longitudinal analysis showed a significant increase in the TA-PI. The UA showed a plateau, but no increase was detected near term. The MCA-PI and CPR showed a progressive decrease in values from inclusion to delivery. Our findings indicate that the increase in the TA-PI was the first sign of the aggravating state of the fetus with the changes registered from the 35th week. The parameters of the UA-PI did not show significant changes, while the MCA and CPR became abnormal later from the 37th week. Conclusions: These observations can serve towards the development of guidelines for detecting the deteriorating signs and intervention timing in IUGR during late pregnancies. MDPI 2022-12-22 /pmc/articles/PMC9821295/ /pubmed/36614891 http://dx.doi.org/10.3390/jcm12010082 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Norvilaitė, Kristina
Ramašauskaitė, Diana
Bartkevičienė, Daiva
Šliachtenko, Aleksandra
Kurmanavičius, Juozas
Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study
title Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study
title_full Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study
title_fullStr Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study
title_full_unstemmed Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study
title_short Fetal Tibial Artery Doppler in Late IUGR Fetuses: A Longitudinal Study
title_sort fetal tibial artery doppler in late iugr fetuses: a longitudinal study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9821295/
https://www.ncbi.nlm.nih.gov/pubmed/36614891
http://dx.doi.org/10.3390/jcm12010082
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