Mathematical simulation of Doppler changes in late-onset smallness; progression patterns of cerebral and umbilical anomalies define two types of late-onset fetal growth restriction.

Data de publicació: 02/09/2021 Data Ahead of Print: 24/10/2019

Autors de IIS La Fe

José Morales Roselló

Autor
Gabriela Alejandra Loscalzo

Autor
David Hervás Marín

Autor
Alfredo José Perales Marín

Autor

Autors aliens a IIS La Fe

Buongiorno, Silvia
Villarroya Alfonso, Benjamin-Remigio

Grups d'Investigació

Medicina Reproductiva

Investigador Principal

José Morales Roselló

Abstract

Objective: To evaluate the progression of Doppler abnormalities in fetuses with late-onset fetal smallness (SGA) that become growth restricted (FGR). Methods: 524 Doppler examinations of the umbilical and cerebral arteries systems, belonging to 442 late-onset SGA fetuses after week 34, were studied, evaluating by means of the statistical difference with the respective abnormal centiles, the pattern of progression into abnormal Doppler values and the distribution and cumulative sum of Doppler anomalies according to the interval to delivery. Results: Only one third (33.5%, N = 148) of late-onset SGA fetuses presented Doppler anomalies, suggesting that most were of constitutional origin. The most frequent progression pattern into abnormal Doppler ( N = 127, 85.81%) was that in which only one system (umbilical or cerebral) became abnormal. Half of fetuses debuted with abnormal umbilical flow (52%, N = 77) and half with cerebral anomalies (47.97%, N = 71), which were more likely to appear later and at shorter intervals to delivery ( p = .007). These progression patters defined two varieties of late-onset FGR (type I and II) with similar outcome but different birth weight centiles (BW centile = 2.51, SD 2.91 versus 3.97, SD 3.17, p < .01). Conclusion: Two thirds of late-onset fetal smallness occurs without hemodynamic changes. In half of the remaining cases an initial cerebral vasodilation defines a group of fetuses with similar outcome but higher BW centile.

Dades de la publicació

ISSN/ISSNe:: 1476-7058, 1476-4954
Tipus:: Article
Pàgines:: 1-11
DOI:: 10.1080/14767058.2019.1671346
PubMed:: 31550946
Factor d'Impacte:: 0,610 SCImago ℠
Quartil:: Q2 SCImago ℠

Documents

No hi ha documents

Mètriques

Filiacions

Morales-Rosello, Jose:: Servicio de Obstetricia, Hospital Universitario y Politécnico La Fe , Valencia , Spain

Departamento de Pediatría, Obstetricia y Ginecología, Universidad de Valencia , Valencia , Spain

Hosp Univ & Politecn La Fe, Serv Obstet, Ave Fernando Abril Martorell 106, Valencia, Spain

Univ Valencia, Dept Pediat Obstet & Ginecol, Valencia, Spain
Buongiorno, Silvia:: Servicio de Obstetricia, Hospital Universitario y Politécnico La Fe , Valencia , Spain

Hosp Univ & Politecn La Fe, Serv Obstet, Ave Fernando Abril Martorell 106, Valencia, Spain
Loscalzo, Gabriela:: Servicio de Obstetricia, Hospital Universitario y Politécnico La Fe , Valencia , Spain

Hosp Univ & Politecn La Fe, Serv Obstet, Ave Fernando Abril Martorell 106, Valencia, Spain
Villarroya Alfonso, Benjamin-Remigio:: Instituto de Investigación. Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe , Valencia , Spain

Instituto de Investigación. Inst Invest Sanitaria La Fe, Unidad Bioestadist, Valencia, Spain
Hervas-Marin, David:: Instituto de Investigación. Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe , Valencia , Spain

Instituto de Investigación. Inst Invest Sanitaria La Fe, Unidad Bioestadist, Valencia, Spain
Perales-Marin, Alfredo:: Servicio de Obstetricia, Hospital Universitario y Politécnico La Fe , Valencia , Spain

Departamento de Pediatría, Obstetricia y Ginecología, Universidad de Valencia , Valencia , Spain

Hosp Univ & Politecn La Fe, Serv Obstet, Ave Fernando Abril Martorell 106, Valencia, Spain

Univ Valencia, Dept Pediat Obstet & Ginecol, Valencia, Spain

Keywords

Fetal hemodynamics, fetal middle cerebral artery, fetal umbilical artery, fetal vertebral artery, late-onset fetal growth restriction, small for gestational age

Campos d'Estudi

Projectes associats

APLICACION DE TECNICAS LAPLACIANAS PARA LA MONITORIZACION DE LA ACTIVIDAD ELECTRICA DEL MUSCULO LISO HUMANO:ENFASIS EN ELECTROHISTEROGRAMA (LAMOHIS)

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

LAMOHIS PLAN NACIONAL I+D+I 2008-2011 . 2010

RED DE SALUD MATERNO INFANTIL Y DEL DESARROLLO

Investigador Principal: MÁXIMO VENTO TORRES

RD12/0026/0012 . INSTITUTO DE SALUD CARLOS III; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2013

CON-CIENCIA-YV: PILDORAS DE SALUD

FCT-13-7457_FECYT_2013 . MINISTERIO DE ECONOMIA Y COMPETITIVIDAD; FUNDACIÓN PARA LA INVESTIGACIÓN DEL HOSPITAL UNIVERSITARIO LA FE DE LA COMUNIDAD VALENCIANA . 2013