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Role of cerebral Blood Flow in Fetal Surveillance

Cheema, Riffat LU (2008) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2008:42.
Abstract
ABSTRACT





In high-risk pregnancies the chronic hypoxemic fetus redistributes its circulation to maintain the blood supply to the vital organs: brain, heart and adrenals. The aims of the studies included in this thesis were: 1) to establish reference curves for fetal cerebral venous blood velocity in normal pregnancies; 2) to determine in high-risk pregnancies the frequency of abnormal Doppler in the cerebral veins and uterine, umbilical and middle cerebral arteries and the umbilical vein and ductus venosus with correlation with adverse perinatal outcome; 3) to analyze the correlation between brain sparing and redistribution of circulation and placental vascular impedance; 4) to evaluate the correlation between... (More)
ABSTRACT





In high-risk pregnancies the chronic hypoxemic fetus redistributes its circulation to maintain the blood supply to the vital organs: brain, heart and adrenals. The aims of the studies included in this thesis were: 1) to establish reference curves for fetal cerebral venous blood velocity in normal pregnancies; 2) to determine in high-risk pregnancies the frequency of abnormal Doppler in the cerebral veins and uterine, umbilical and middle cerebral arteries and the umbilical vein and ductus venosus with correlation with adverse perinatal outcome; 3) to analyze the correlation between brain sparing and redistribution of circulation and placental vascular impedance; 4) to evaluate the correlation between brain sparing and fetal umbilical cord blood gases at birth.



Pulsating Galen vein was seen in 8% of the normal and 58% of the high-risk pregnancies. The degree of brain sparing was strongly related to the increasing placental vascular resistance. Despite signs of brain sparing, the chronic hypoxemic fetuses managed to maintain their cord blood gases at birth. A strong correlation was found between signs of brain sparing and operative delivery for fetal distress, admission to neonatal intensive care unit, and small-for-gestational-age newborn. The results suggest that uterine, umbilical and middle cerebral arteries and Galen vein show early Doppler changes during surveillance, whereas the ductus venosus and umbilical vein might show late Doppler changes in cases of suspected chronic hypoxemia. Umbilical venous pulsations were most predictive of adverse perinatal outcome. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Arbeille, Phillipe, Tours, France
organization
publishing date
type
Thesis
publication status
published
subject
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2008:42
pages
134 pages
publisher
Department of Clinical Sciences, Lund University
defense location
Kvinnokliniken UMAS, malmö
defense date
2008-04-11 09:00
ISSN
1652-8220
ISBN
978-91-85897-95-7
language
English
LU publication?
yes
id
547113b8-0487-4e8a-9d3b-99dadce90767 (old id 1150476)
date added to LUP
2008-05-23 13:53:25
date last changed
2016-09-19 08:44:50
@phdthesis{547113b8-0487-4e8a-9d3b-99dadce90767,
  abstract     = {ABSTRACT<br/><br>
<br/><br>
<br/><br>
In high-risk pregnancies the chronic hypoxemic fetus redistributes its circulation to maintain the blood supply to the vital organs: brain, heart and adrenals. The aims of the studies included in this thesis were: 1) to establish reference curves for fetal cerebral venous blood velocity in normal pregnancies; 2) to determine in high-risk pregnancies the frequency of abnormal Doppler in the cerebral veins and uterine, umbilical and middle cerebral arteries and the umbilical vein and ductus venosus with correlation with adverse perinatal outcome; 3) to analyze the correlation between brain sparing and redistribution of circulation and placental vascular impedance; 4) to evaluate the correlation between brain sparing and fetal umbilical cord blood gases at birth.<br/><br>
<br/><br>
Pulsating Galen vein was seen in 8% of the normal and 58% of the high-risk pregnancies. The degree of brain sparing was strongly related to the increasing placental vascular resistance. Despite signs of brain sparing, the chronic hypoxemic fetuses managed to maintain their cord blood gases at birth. A strong correlation was found between signs of brain sparing and operative delivery for fetal distress, admission to neonatal intensive care unit, and small-for-gestational-age newborn. The results suggest that uterine, umbilical and middle cerebral arteries and Galen vein show early Doppler changes during surveillance, whereas the ductus venosus and umbilical vein might show late Doppler changes in cases of suspected chronic hypoxemia. Umbilical venous pulsations were most predictive of adverse perinatal outcome.},
  author       = {Cheema, Riffat},
  isbn         = {978-91-85897-95-7},
  issn         = {1652-8220},
  language     = {eng},
  pages        = {134},
  publisher    = {Department of Clinical Sciences, Lund University},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {Role of cerebral Blood Flow in Fetal Surveillance},
  volume       = {2008:42},
  year         = {2008},
}