WS17‐09Doppler flow measurements and neuromotoric morbidity

Abstract

BackgroundAbsent enddiastolic flow (AEDF) velocities are associated with fetal distress and adverse fetal outcome. The aim of this study was to evaluate perinatal findings of fetuses with an AEDF in fetal vessels and to investigate the neurological long‐term‐outcome.MethodThe analytical program ‘Munich functional developmental diagnostics’ (MFDD) was applied to the 90 children at different time intervals. The results of 40 children with an AEDF (Gr. I) and 20 children with pathological S/D‐Ratio (Gr. II) were compared to the group of 30 children with normal Doppler‐flow‐findings (Gr. III) with the same pregnancy weeks at birth.ResultsThe rate of C‐section (92% vs. 71% vs. 36%), birthweight (1140g vs. 1725g vs. 2570g), 5′min. APGAR‐Score (31% vs. 5% both) were significantly different in three groups. Brain sparing effect in the middle cerebral arteries was found in 81% in Gr. I, in 21% Gr. II and only 8% in Gr. III. At the time of neurological assessment the age of children was between 12 and 36 months. The developmental age for each functional category was evaluated and the difference between corrected age and developmental age was calculated. In 33% of all infants with a AEDF had a pathological neuromotoric development vs. 22% in Gr. II and only 15.3% in Gr. III.ConclusionsThe children with pathological Doppler‐flow‐measurements during pregnancy have not only very high risk of perinatal abnormality but also show a distinctly increased risk of impaired growth and neurodevelopmental disability comparing to the cases with a normal Doppler‐flow‐finding. Most of these fetuses showed brain‐sparing effect. These aspects are very important to be discussed with the parents before the definitive perinatal decision is made.