Academic Journal
Evidence of second‐trimester changes in head biometry and brain perfusion in fetuses with congenital heart disease
| العنوان: | Evidence of second‐trimester changes in head biometry and brain perfusion in fetuses with congenital heart disease |
|---|---|
| المؤلفون: | Masoller, N., Martínez, J. M., Gómez, O., Bennasar, M., Crispi, F., Sanz‐Cortés, M., Egaña‐Ugrinovic, G., Bartrons, J., Puerto, B., Gratacós, E. |
| المساهمون: | Fondo Europeo de Desarrollo Regional de la Uni�n Europea Una manera de hacer, Instituto de Salud Carlos III |
| المصدر: | Ultrasound in Obstetrics & Gynecology ; volume 44, issue 2, page 182-187 ; ISSN 0960-7692 1469-0705 |
| بيانات النشر: | Wiley |
| سنة النشر: | 2014 |
| المجموعة: | Wiley Online Library (Open Access Articles via Crossref) |
| الوصف: | Objectives To evaluate the associations between congenital heart disease ( CHD ) and head biometry and cerebrovascular blood flow dynamics at the time of diagnosis of CHD in the second trimester of pregnancy. Methods This was a study of 95 consecutive fetuses diagnosed with CHD . At the time of diagnosis, fetal biometry was performed and brain perfusion was assessed by middle cerebral artery pulsatility index ( MCA‐PI ), cerebroplacental ratio ( CPR ) and fractional moving blood volume ( FMBV ). The results were compared with those of 95 normal fetuses matched for gestational age. Results Median gestational age at diagnosis was 22 + 3 (range, 20 + 0 to 23 + 5) weeks. Fetuses with CHD showed significantly lower MCA‐PI and CPR Z ‐scores (−0.23 vs 0.34 and −0.37 vs 0.30, respectively; both P < 0.001) and higher FMBV Z ‐scores (2.35 vs 0.15; P < 0.001). FMBV > 95 th percentile was observed in 81.1% of cases as compared with 10.5% in controls ( P < 0.001). Moreover, cases showed significantly smaller biparietal diameter ( BPD ) and head circumference ( HC ) Z ‐scores (−1.61 vs − 0.43 and −0.89 vs 0.09, respectively; both P < 0.001), with a higher proportion of BPD and HC measurements below the 5 th percentile compared with controls (51.6% vs 13.7% and 26.3% vs 4.2%, respectively; both P < 0.001). These findings were more pronounced in those cases with types of CHD associated with compromised oxygenated blood delivery to the brain, such as left outflow tract obstruction and transposition of the great arteries. Conclusions A high proportion of fetuses with CHD have a smaller head and increased brain perfusion already in the second trimester, suggesting an early onset of the mechanisms leading to poorer neurodevelopment later in life. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1002/uog.13373 |
| الاتاحة: | http://dx.doi.org/10.1002/uog.13373 https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fuog.13373 https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1002/uog.13373 |
| Rights: | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| رقم الانضمام: | edsbas.D42AD3B7 |
| قاعدة البيانات: | BASE |
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