WS08‐04Fetal brain: cerebral and cerebellar circulation in early fetal jeopardization

Abstract

BackgroundThe aim of this study was to investigate with color‐power doppler sonography the arterial and venous circulation in fetal brain, in normal and pathologic circumstances.MethodWe studied 101 appropriate for gestational age (AGA) fetuses, 20 intrauterine growth‐retarded fetuses (IUGR), 10 fetuses with cmv infections and 10 fetuses with supraventricular tachycardia.In all fetuses we obtained reliable blood flow velocity waveforms of middle cerebral and superior cerebellar artery and trasverse sinus.The pulsatility index (PI) for arterial vessels and flow velocity for venous vessels were used. Doppler measurements of AGA fetuses were compared with other fetuses.ResultsAn increase in fetal middle cerebral PI and cerebral transverse sinus was observed in IUGR and a slightly decrease in case of fetal arrhytmia when compared with AGA fetuses. In 6 of 10 fetuses affected by cmv infection was observed a reduction in PI cerebral and cerebellar, while no difference was found for venous velocities.A longitudinal study was performed in 30 AGA and 8 IUGR fetuses. The IUGR fetuses showed a characteristic early reduction of cerebellar PI in respect to cerebral PI about 4–8 days prior the evidence of late heart rate (HR) decelerations; however, the two vessels did not differ significantly in the 4 days prior HR decelerations.ConclusionVenous and arterial cerebral circulation shown a response to pathological conditions that could affect fetal brain.