Abstract
Purpose: to study, in high risk pregnancies with cerebral redistribution of blood flow, the fetal surveillance and perinatal outcome, according to umbilical artery dopplervelocimetry. Methods: a total of 717 high-risk pregnancies attended at the Fetal Surveillance Unit were included. The last examination performed until 72 h prior to delivery was taken into account. Multiple gestations and fetal anomalies were excluded. The redistribution of blood flow was diagnosed if the pulsatility index of middle cerebral artery was below the 5th percentile for gestational age. The umbilical artery dopplervelocimetry was abnormal when A/B ratio was more than the 95th p. Results: in the group with normal umbilical artery dopplervelocimetry (560 cases ¾ 78.1%), significant correlation was found only between redistribution of blood flow and suspected or abnormal cardiotocography (17.1%). In the group with abnormal umbilical artery dopplervelocimetry (157 cases ¾ 21.9%) we found significant correlation between redistribution of blood flow (105 cases ¾ 66.9%) and cardiotocography abnormalities (57.2%), abnormal 1st (43.8%) and 5th (12.4%) minute Apgar scores. In these cases, the mean values of gestational age at delivery (34.4 ± 3.6 weeks), birth weight (1,810.5 ± 769.3 g), and pH at birth (7.20 ± 0.1) were significantly lower. Conclusion: The redistribution of fetal blood flow characterized by means of middle cerebral artery dopplervelocimetry is related to perinatal results when some level of placental insufficiency occurs, and does not present association to perinatal outcome when pregnancy shows normal fetal-placental blood flow.
Highlights
16.Trudinger BJ, Giles WB, Cook CM, Bombardieri J, Collins L
Tabela 2 - Distribuição da população segundo os resultados dos testes de avaliação da vitalidade fetal de acordo com o resultado da dopplervelocimetria da artéria umbilical e da artéria cerebral média
Methods: a total of 717 high-risk pregnancies attended at the Fetal Surveillance Unit were included
Summary
Centralização da Circulação Fetal em Gestações de Alto Risco: Avaliação da Vitalidade Fetal e Resultados Perinatais. Objetivos: analisar, nas gestações de alto risco com diagnóstico de centralização da circulação fetal, os resultados perinatais e a avaliação da vitalidade fetal de acordo com a dopplervelocimetria da artéria umbilical (AU). Conclusões: o diagnóstico da centralização da circulação fetal pela dopplervelocimetria da ACM é significativo apenas em gestações que cursam com algum grau de insuficiência placentária, não se relacionando com piora dos resultados perinatais em gestantes com função placentária normal. Este estudo tem como objetivo analisar, nas gestações de alto risco, a correlação entre o diagnóstico de centralização da circulação fetal pela avaliação da dopplervelocimetria da ACM e os resultados perinatais, e a avaliação da vitalidade fetal, levando em consideração os resultados da dopplervelocimetria da artéria umbilical (AU)
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