Signs of fetal brain sparing are not related to umbilical cord blood gases at birth.

Riffat Cheema; Mariusz Dubiel; Saemundur Gudmundsson

doi:10.1016/j.earlhumdev.2009.04.003

Signs of fetal brain sparing are not related to umbilical cord blood gases at birth.

Riffat Cheema, Mariusz Dubiel, Saemundur Gudmundsson

Urogynaecology and Reproductive Pharmacology

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing. AIM: Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth. STUDY DESIGN: A prospective study. SUBJECTS: Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies). METHODS: MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth. MAIN OUTCOME MEASURES: Cord blood gases were related to signs of centralization of fetal circulation in the MCA. RESULTS: No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5'<7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p<0.04) and had a longer duration of stay in NICU (p<0.03) compared to newborns without brain sparing. CONCLUSION: Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia.

Original language	English
Pages (from-to)	467-470
Journal	Early Human Development
Volume	85
DOIs	https://doi.org/10.1016/j.earlhumdev.2009.04.003
Publication status	Published - 2009

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Research Unit for Urogynaecology and Reproductive Pharmacology (013242710), Pediatrics/Urology/Gynecology/Endocrinology (013240400)

Subject classification (UKÄ)

Clinical Medicine
Obstetrics, Gynecology and Reproductive Medicine

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10.1016/j.earlhumdev.2009.04.003

http://www.ncbi.nlm.nih.gov/pubmed/19395205?dopt=Abstract

Cite this

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title = "Signs of fetal brain sparing are not related to umbilical cord blood gases at birth.",

abstract = "BACKGROUND: Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing. AIM: Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth. STUDY DESIGN: A prospective study. SUBJECTS: Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies). METHODS: MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth. MAIN OUTCOME MEASURES: Cord blood gases were related to signs of centralization of fetal circulation in the MCA. RESULTS: No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5'<7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p<0.04) and had a longer duration of stay in NICU (p<0.03) compared to newborns without brain sparing. CONCLUSION: Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia.",

author = "Riffat Cheema and Mariusz Dubiel and Saemundur Gudmundsson",

note = "The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Research Unit for Urogynaecology and Reproductive Pharmacology (013242710), Pediatrics/Urology/Gynecology/Endocrinology (013240400)",

year = "2009",

doi = "10.1016/j.earlhumdev.2009.04.003",

language = "English",

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pages = "467--470",

journal = "Early Human Development",

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T1 - Signs of fetal brain sparing are not related to umbilical cord blood gases at birth.

AU - Cheema, Riffat

AU - Dubiel, Mariusz

AU - Gudmundsson, Saemundur

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Research Unit for Urogynaecology and Reproductive Pharmacology (013242710), Pediatrics/Urology/Gynecology/Endocrinology (013240400)

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing. AIM: Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth. STUDY DESIGN: A prospective study. SUBJECTS: Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies). METHODS: MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth. MAIN OUTCOME MEASURES: Cord blood gases were related to signs of centralization of fetal circulation in the MCA. RESULTS: No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5'<7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p<0.04) and had a longer duration of stay in NICU (p<0.03) compared to newborns without brain sparing. CONCLUSION: Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia.

AB - BACKGROUND: Fetal chronic hypoxia leads to centralization of circulation in order to spare the vital organs brain, adrenals and the heart. This can be documented by Doppler ultrasound. Increased blood velocity in the fetal middle cerebral artery (MCA) is an acknowledged sign of centralization of circulation in chronic hypoxia, and is called brain sparing. AIM: Our aim was to assess the relationship between signs of brain sparing in the MCA and umbilical cord blood gases at birth. STUDY DESIGN: A prospective study. SUBJECTS: Singleton 57 high-risk pregnancies (outcome was compared with 21 normal pregnancies). METHODS: MCA Doppler was performed within 24 h of elective caesarean section in high-risk pregnancies. Umbilical cord blood gases were analysed at birth. MAIN OUTCOME MEASURES: Cord blood gases were related to signs of centralization of fetal circulation in the MCA. RESULTS: No correlation between signs of brain sparing in the MCA and cord blood gases. Apgar score at 5'<7 was seen in three newborns, but only one of these had antenatal signs of brain sparing. Newborns with antenatal brain sparing were admitted more often (p<0.04) and had a longer duration of stay in NICU (p<0.03) compared to newborns without brain sparing. CONCLUSION: Decreased pulsatility index in MCA is an acknowledged sign of fetal centralization of circulation during chronic hypoxia. However, signs of brain sparing are not related to cord blood gases at birth, which might suggest that redistribution of fetal circulation can maintain normal blood gases for a long time during chronic hypoxia.

U2 - 10.1016/j.earlhumdev.2009.04.003

DO - 10.1016/j.earlhumdev.2009.04.003

M3 - Article

C2 - 19395205

SN - 1872-6232

VL - 85

SP - 467

EP - 470

JO - Early Human Development

JF - Early Human Development

ER -

Signs of fetal brain sparing are not related to umbilical cord blood gases at birth.

Abstract

Bibliographical note

Subject classification (UKÄ)

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