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Blood redistribution in the fetal brain during chronic hypoxia

Dubiel, M; Gunnarsson, Gudmundur LU and Gudmundsson, S (2002) In Ultrasound in Obstetrics & Gynecology 20(2). p.117-121
Abstract
Background Studies on blood flow velocity in the fetal middle cerebral artery have revealed signs of brain sparing in chronic hypoxia. These signs of brain sparing can disappear in the terminal case, but whether this applies to the whole brain or only parts of it is unknown. Methods Velocity waveforms of the middle cerebral, anterior cerebral and posterior cerebral arteries were recorded in 221 pregnancies complicated by pregnancy-induced hypertension. The presence of brain sparing (pulsatility index < 2 standard deviations) was noted and correlated to outcome of pregnancy, including emergency operative intervention and/or neonatal distress. Results Signs of brain sparing in the anterior cerebral artery were found in 90 fetuses, and in... (More)
Background Studies on blood flow velocity in the fetal middle cerebral artery have revealed signs of brain sparing in chronic hypoxia. These signs of brain sparing can disappear in the terminal case, but whether this applies to the whole brain or only parts of it is unknown. Methods Velocity waveforms of the middle cerebral, anterior cerebral and posterior cerebral arteries were recorded in 221 pregnancies complicated by pregnancy-induced hypertension. The presence of brain sparing (pulsatility index < 2 standard deviations) was noted and correlated to outcome of pregnancy, including emergency operative intervention and/or neonatal distress. Results Signs of brain sparing in the anterior cerebral artery were found in 90 fetuses, and in the middle cerebral and posterior cerebral arteries in 52 and 65, respectively. Signs of brain sparing in the anterior cerebral artery showed the strongest relationship to adverse perinatal outcome. The anterior cerebral artery was the only vessel in which signs of brain sparing were predictive of perinatal mortality. Conclusions Velocimetry of the anterior cerebral artery appears to be superior to that of the middle cerebral and posterior cerebral arteries as a means to predict adverse perinatal outcome. Anterior cerebral artery brain sparing may therefore be less transitory than sparing in the middle cerebral and posterior cerebral arteries, possibly suggesting that the frontal lobes are spared longer than the lateral and occipital regions of the fetal brain. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
brain, fetus, ultrasound, regional blood flow, physiology
in
Ultrasound in Obstetrics & Gynecology
volume
20
issue
2
pages
117 - 121
publisher
John Wiley & Sons
external identifiers
  • pmid:12153660
  • wos:000177259100003
  • scopus:0036421201
ISSN
1469-0705
DOI
10.1046/j.1469-0705.2002.00758.x
language
English
LU publication?
yes
id
a2c87088-b8dc-4921-a72f-a4a0da79640e (old id 331884)
date added to LUP
2007-08-16 10:54:30
date last changed
2017-09-10 04:30:08
@article{a2c87088-b8dc-4921-a72f-a4a0da79640e,
  abstract     = {Background Studies on blood flow velocity in the fetal middle cerebral artery have revealed signs of brain sparing in chronic hypoxia. These signs of brain sparing can disappear in the terminal case, but whether this applies to the whole brain or only parts of it is unknown. Methods Velocity waveforms of the middle cerebral, anterior cerebral and posterior cerebral arteries were recorded in 221 pregnancies complicated by pregnancy-induced hypertension. The presence of brain sparing (pulsatility index &lt; 2 standard deviations) was noted and correlated to outcome of pregnancy, including emergency operative intervention and/or neonatal distress. Results Signs of brain sparing in the anterior cerebral artery were found in 90 fetuses, and in the middle cerebral and posterior cerebral arteries in 52 and 65, respectively. Signs of brain sparing in the anterior cerebral artery showed the strongest relationship to adverse perinatal outcome. The anterior cerebral artery was the only vessel in which signs of brain sparing were predictive of perinatal mortality. Conclusions Velocimetry of the anterior cerebral artery appears to be superior to that of the middle cerebral and posterior cerebral arteries as a means to predict adverse perinatal outcome. Anterior cerebral artery brain sparing may therefore be less transitory than sparing in the middle cerebral and posterior cerebral arteries, possibly suggesting that the frontal lobes are spared longer than the lateral and occipital regions of the fetal brain.},
  author       = {Dubiel, M and Gunnarsson, Gudmundur and Gudmundsson, S},
  issn         = {1469-0705},
  keyword      = {brain,fetus,ultrasound,regional blood flow,physiology},
  language     = {eng},
  number       = {2},
  pages        = {117--121},
  publisher    = {John Wiley & Sons},
  series       = {Ultrasound in Obstetrics & Gynecology},
  title        = {Blood redistribution in the fetal brain during chronic hypoxia},
  url          = {http://dx.doi.org/10.1046/j.1469-0705.2002.00758.x},
  volume       = {20},
  year         = {2002},
}