nach oben

Archives of Gynecology and Obstetrics

Erschienen in:

01.06.2012 | Maternal-Fetal Medicine

Postnatal neuro-development of fetuses with absent end-diastolic flow in the umbilical artery and/or fetal descending aorta

verfasst von: A. Kubilay Ertan, H. Alper Tanriverdi, Alexander Stamm, Wolfgang Jost, Jan Endrikat, Werner Schmidt

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 6/2012

Einloggen, um Zugang zu erhalten

Abstract

Objective

To determine whether absence of end-diastolic flow in the umbilical artery and/or fetal aorta impacts postnatal neuro-development in preterm-born children.

Methods

The study group, consisting of 43 fetuses with absent end-diastolic flow in the umbilical artery and/or fetal aorta, was compared with a control group, consisting of 30 fetuses, matching for gestational age but with normal doppler-flow results. The children’s neuro-developmental status was assessed using the ‘Munich functional developmental diagnostics’ (MFDD), between the 2nd and 3rd year of life.

Results

Gestational age at birth was 33 + 6 weeks in the study group and 34 + 4 weeks in the control group. A brain-sparing effect was observed in 37.3% of fetuses in the study group compared with 10.0% in the control group (p = 0.014). For all seven MFDD domains, the number of children with deficiencies was higher in the study group. For the domains perception, active speech and comprehension this effect was statistically significant (p < 0.05). Overall, 30.2% of children in the study group and 16.7% of the control group had pathologic test results (p < 0.013).

Conclusion

Pathological doppler-flow in the umbilical artery and/or fetal descending aorta in preterm born children is associated with neuro-developmental deficiencies. Intensive pediatric care is recommended to mitigate these deficiencies during early childhood.

Vossbeck S, de Camargo OK, Grab D, Bode H, Pohlandt F (2001) Neonatal and neurodevelopmental outcome in infants born before 30 weeks of gestation with absent or reversed end-diastolic flow velocities in the umbilical artery. Eur J Pediatr 160(2):128–134PubMedCrossRef

Kutschera J, Tomaselli J, Urlesberger B, Maurer U, Hausler M, Gradnitzer E et al (2002) Absent or reversed end-diastolic blood flow in the umbilical artery and abnormal Doppler cerebroplacental ratio-cognitive, neurological and somatic development at 3 to 6 years. Early Hum Dev 69(1–2):47–56PubMedCrossRef

Eixarch E, Meler E, Iraola A, Illa M, Crispi F, Hernandez-Andrade E et al (2008) Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational age term fetuses with cerebral blood flow redistribution. Ultrasound Obstet Gynecol 32(7):894–899PubMedCrossRef

Fitzhardinge PM, Steven EM (1972) The small-for-date infant. II. Neurological and intellectual sequelae. Pediatrics 50(1):50–57PubMed

Paz I, Gale R, Laor A, Danon YL, Stevenson DK, Seidman DS (1995) The cognitive outcome of full-term small for gestational age infants at late adolescence. Obstet Gynecol 85(3):452–456PubMedCrossRef

Strauss RS (2000) Adult functional outcome of those born small for gestational age: twenty-six-year follow-up of the 1970 British birth cohort. JAMA 283(5):625–632PubMedCrossRef

Sung IK, Vohr B, Oh W (1993) Growth and neurodevelopmental outcome of very low birth weight infants with intrauterine growth retardation: comparison with control subjects matched by birth weight and gestational age. J Pediatr 123(4):618–624PubMedCrossRef

Ertan AK, Hendrik HJ, Schmidt W (2001) Hochpathologische Dopplerflowbefunde und perinatale auffaelligkeiten (Chapter 19). In: Schmidt W, Kurjak A (eds) Farbdopplersonographie in gynäkologie und geburtshilfe, 1st edn. Georg Thieme Verlag, Stuttgart, pp 177–187

Jang DG, Jo YS, Lee SJ, Kim N, Lee GS (2011) Perinatal outcomes and maternal clinical characteristics in IUGR with absent or reversed end-diastolic flow velocity in the umbilical artery. Arch Gynecol Obstet 284(1):73–78PubMedCrossRef

10.

Adiotomre PN, Johnstone FD, Laing IA (1997) Effect of absent end diastolic flow velocity in the fetal umbilical artery on subsequent outcome. Arch Dis Child Fetal Neonatal Ed 76(1):F35–F38PubMedCrossRef

11.

Ley D, Tideman E, Laurin J, Bjerre I, Marsal K (1996) Abnormal fetal aortic velocity waveform and intellectual function at 7 years of age. Ultrasound Obstet Gynecol 8(3):160–165PubMedCrossRef

12.

Ley D, Laurin J, Bjerre I, Marsal K (1996) Abnormal fetal aortic velocity waveform and minor neurological dysfunction at 7 years of age. Ultrasound Obstet Gynecol 8(3):152–159PubMedCrossRef

13.

Wienerroither H, Steiner H, Tomaselli J, Lobendanz M, Thun-Hohenstein L (2001) Intrauterine blood flow and long-term intellectual, neurologic, and social development. Obstet Gynecol 97(3):449–453PubMedCrossRef

14.

Papile LA, Burstein J, Burstein R, Koffler H (1978) Incidence and evolution of subependymale and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 g. J Pediatr 92:529–534PubMedCrossRef

15.

Schmidt W, Graf von Ballestrem CL, Ertan AK, Ruhle W, Gnirs J, Boos R (1991) [Pathologic Doppler flow findings and cardiotocography results]. Geburtshilfe Frauenheilkd 51(7):523–531PubMedCrossRef

16.

Vasconcelos RP, Brazil Frota Aragão JR, Costa Carvalho FH, Salani Mota RM, de Lucena Feitosa FE, Alencar Júnior CA (2010) Differences in neonatal outcome in fetuses with absent versus reverse end-diastolic flow in umbilical artery Doppler. Fetal Diagn Ther 28:160–166PubMedCrossRef

17.

Ertan AK, Hendrik HJ, Tanriverdi HA, Bechtold M, Schmidt W (2003) Fetomaternal Doppler sonography nomograms. Clin Exp Obstet Gynecol 30(4):211–216PubMed

18.

Hellbrügge T, Lajosi F, Menara D, Schamberger R, Rautenstrauch T (1978) Münchner funktionelle entwicklungsdiagnostik: erstes lebensjahr, 1st edn. Hansisches Verlagskontor, Lübeck

19.

Köhler G, Egelkraut H (1984) Münchner Funktionelle Entwicklungsdiagnostik für das zweite und dritte Lebensjahr. Eigenverlag der Aktion Sonnenschein

20.

Valcamonico A, Danti L, Frusca T, Soregaroli M, Zucca S, Abrami F et al (1994) Absent end-diastolic velocity in umbilical artery: risk of neonatal morbidity and brain damage. Am J Obstet Gynecol 170(3):796–801PubMed

21.

Brar HS, Platt LD (1988) Reverse end-diastolic flow velocity on umbilical artery velocimetry in high-risk pregnancies: an ominous finding with adverse pregnancy outcome. Am J Obstet Gynecol 159(3):559–561PubMed

22.

Makhseed M, Jirous J, Ahmed MA, Viswanathan DL (2000) Middle cerebral artery to umbilical artery resistance index ratio in the prediction of neonatal outcome. Int J Gynaecol Obstet 71(2):119–125PubMedCrossRef

23.

Martins Neto M, Carvalho FH, Mota RM, Alencar Júnior CA (2010) Predictor parameters of neonatal death in gestations with absent or reverse end-diastolic flow in the umbilical artery Doppler velocimetry. Rev Bras Ginecol Obstet 32:352–358PubMedCrossRef

24.

Schmidt W, Ertan A, Rühle W, von Ballestrem C, Gnirs J, Boos R (1991) Dopplersonographie: „Enddiastolischer Block bzw. Reverse Flow”—Perinatologische Daten und geburtshilfliches Management Jahrbuch der Gynäkologie und Geburtshilfe, 1st edn. Stuttgart: Biermann, Germany

25.

Schulman H, Winter D, Farmakides G, Coury A, Schneider E, Penny B (1989) Doppler examinations of the umbilical and uterine arteries during pregnancy. Clin Obstet Gynecol 32(4):738–745PubMedCrossRef

26.

Tolsa CB, Zimine S, Warfield SK, Freschi M, Sancho RA, Lazeyras F et al (2004) Early alteration of structural and functional brain development in premature infants born with intrauterine growth restriction. Pediatr Res 56(1):132–138PubMedCrossRef

27.

Ertan AK, Jost W, Hendrik HJ, Lauer S, Uhrmacher S, Schmidt W (1993) Perinatal events and neuromotoric development of children with zero flow in the fetal vessels during the last trimester. In: Cosmi E, Di Renzo GC (eds) 2nd World congress of perinatal medicine, 1st edn. Monduzzi Editore, Milano, pp 1049–1052

28.

Matilainen R, Heinonen K, Siren-Tiusanen H, Jokela V, Launiala K (1987) Neurodevelopmental screening of in utero growth-retarded prematurely born children before school age. Eur J Pediatr 146(5):453–457PubMedCrossRef

29.

Vojta V (1965) Rehabilitation of the spastic infantile syndrome. Personal methodology. Beitr Orthop Traumatol 12(9):557–562PubMed

30.

Vohr BR, Oh W (1983) Growth and development in preterm infants small for gestational age. J Pediatr 103(6):941–945PubMedCrossRef

31.

Low JA, Handley-Derry M, Burke J, Peters E, Killen H, Derrick E (1992) Association of intrauterine growth retardation and learning deficits at age 9 to 11 years. Am J Obstet Gynecol 167(6):1499–1505PubMed

32.

Leppanen M, Ekholm E, Palo P, Maunu J, Munck P, Parkkola R et al (2010) Abnormal antenatal Doppler velocimetry and cognitive outcome in very-low-birth-weight infants at 2 years of age. Ultrasound Obstet Gynecol 36(2):178–185PubMedCrossRef

33.

Maunu J, Ekholm E, Parkkola R, Palo P, Rikalainen H, Lapinleimu H et al (2007) Antenatal Doppler measurements and early brain injury in very low birth weight infants. J Pediatr 150(1):51–56PubMedCrossRef

34.

Vohr B, Garcia Coll C (1985) Neurodevelopmental and school performance of very low-birth-weight infants: a seven-year longitudinal study. Pediatrics 76(3):345–350PubMed

35.

Backer A, Pauli-Pott U, Neuhauser G, Beckmann D (2000) Effects of significantly increased perinatal risks on developmental status in adolescence. Prax Kinderpsychol Kinderpsychiatr 49(6):385–398PubMed

36.

McCarton CM, Brooks-Gunn J, Wallace IF, Bauer CR, Bennett FC, Bernbaum JC et al (1997) Results at age 8 years of early intervention for low-birth-weight premature infants. The infant health and development program. JAMA 277(2):126–132PubMedCrossRef

37.

Vohr BR, Garcia-Coll C, Oh W (1989) Language and neurodevelopmental outcome of low-birthweight infants at three years. Dev Med Child Neurol 31(5):582–590PubMedCrossRef

38.

Lacey J (2001) Very low-birthweight preterm infants walk later than term infants, but most are walking by 18 months. Aust J Physiother 47(1):65PubMed

Titel: Postnatal neuro-development of fetuses with absent end-diastolic flow in the umbilical artery and/or fetal descending aorta
verfasst von: A. Kubilay Ertan
H. Alper Tanriverdi
Alexander Stamm
Wolfgang Jost
Jan Endrikat
Werner Schmidt
Publikationsdatum: 01.06.2012
Verlag: Springer-Verlag
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 6/2012
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-011-2191-4

Neu im Fachgebiet Gynäkologie und Geburtshilfe

23.04.2024 | Medikamente in Schwangerschaft und Stillzeit | Nachrichten

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen

Springer Medizin

Postnatal neuro-development of fetuses with absent end-diastolic flow in the umbilical artery and/or fetal descending aorta

Abstract

Objective

Methods

Results

Conclusion

Neu im Fachgebiet Gynäkologie und Geburtshilfe

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Gynäkologie

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2012

Effect of liquid-based gel application during speculum examination on satisfactory level of smear examination

Appropriate interval between endometrial polyp resection and the proceeding IVF start

Successful pregnancy following myomectomy of a giant uterine myoma: role of a combined surgical approach

Women’s well-being after Manchester procedure for pelvic reconstruction with uterine preservation: a follow-up study

Outcomes and toxicities for the treatment of stage IVB cervical cancer

Type I collagen and matrix metalloproteinase 1, 3 and 9 gene polymorphisms in the predisposition to pelvic organ prolapse

Neu im Fachgebiet Gynäkologie und Geburtshilfe

ICI-Therapie in der Schwangerschaft wird gut toleriert

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

Bei RSV-Impfung vor 60. Lebensjahr über Off-Label-Gebrauch aufklären!

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

Update Gynäkologie