Vol 80, No 11 (2009)
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Do abnormal results of Doppler examinations in fetuses with growth restriction increase the frequency of postnatal complications of the central nervous system and gastrointestinal tract?

Jana M. Skrzypczak, Tomasz Goździewicz, Marcin Rajewski, Alicja Kornacka, Jakub Kornacki, Jerzy Szczapa
Ginekol Pol 2009;80(11).

Abstract

Abstract Objectives: The aim of the work was to assess the correlations between the results of antenatal Doppler examinations in fetuses with growth restriction (IUGR) and the frequency of postnatal complications of central nervous system and gastrointestinal tract. Material and methods: 47 pregnant women and 47 fetuses and newborns from singleton pregnancies with diagnosed intrauterine growth restriction. Two groups of fetuses (newborns) were distinguished based on serial Doppler examinations of fetal umbilical and middle cerebral arteries: 1) newborns with IUGR and abnormal results of antenatal Doppler examinations (group 1); 2) newborns with IUGR and normal results of antenatal Doppler examinations (group 2). The analysis concerned such neonatal complications as intraventricular hemorrhages (IVH) of III and IV degree, leucomalacias and necrotizing eneterocollits (NEC). Results: Among 47 neonates, the abnormal results of Doppler examinations were found in 21 of them, and in the rest of the newborns (26) there were no abnormalities in Doppler antenatal examinations. The frequency of intraventricular hemorrhages of III and IV degree, neonatal leucomalacias and necrotizing eneterocollits did not differ significantly between the groups. The mean time of hospitalization in newborns with abnormal results of antenatal Doppler examinations was significantly longer than in neonates whose antenatal Doppler tests were normal (14 days vs 10 days). The newborns from group 1 required parenteral feeding significantly more often than the newborns from group 2 (28,9% vs 12%). Conclusions: The comparable frequency of central nervous system complications in newborns with abnormal and in neonates with normal results of antenatal Doppler examinations may indicate on effective role of brain sparing effect in fetuses with IUGR as a mechanism which reduces the likelihood of hypoxemic complications in the developing fetal brain. The newborns with IUGR and abnormal results of antenatal Doppler test require both a longer hospitalization and the necessity of parenteral feeding when compared with newborns with IUGR and normal antenatal Doppler test results. Newborns who were diagnosed with absent or reversed end-diastolic flow in umbilical artery are particularly at risk of central nervous system complications.

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