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Reduced fetal movements and cerebroplacental ratio: evidence for worsening fetal hypoxemia

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Binder, J
  • Monaghan, C
  • Thilaganathan, B
  • Khalil, A

Grupos

Abstract

Objective To investigate the fetal cerebroplacental ratio (CPR) in women presenting with reduced fetal movements (RFM). Methods This was a retrospective cohort study of data collected over an 8-year period at a fetal medicine unit at a tertiary referral center. The cohort comprised 4500 singleton pregnancies presenting with RFM at or after 36 weeks' gestation and 1527 control pregnancies at a similar gestational age without RFM. Fetal biometry and Doppler parameters were recorded and converted into centiles and multiples of the median (MoM). CPR was defined as the ratio between the fetal middle cerebral artery (MCA) pulsatility index (PI) and the umbilical artery (UA) PI. Subgroup analysis for fetal size and for single vs multiple episodes of RFM was performed. Results Compared with controls, pregnancies with RFM had lower MCA-PI MoM (median, 0.95 vs 0.97; P < 0.001) and CPR MoM (median, 0.97 vs 0.99; P = 0.018). Compared with women presenting with single episodes of RFM, pregnancies with multiple episodes (>= 2 episodes) had lower CPR MoM (median, 0.94 vs 0.98; P = 0.003). On subgroup analysis for fetal size, compared with controls, appropriate-for-gestational-age fetuses in the RFM group had lower MCA-PI MoM (median, 0.96 vs 0.97; P = 0.003) and higher rate of CPR below the 5th centile (5.3% vs 3.6%; P = 0.015). Logistic regression analysis demonstrated an association of risk of recurrent RFM with maternal age (OR, 0.96; 95% CI, 0.93-0.99), non-Caucasian ethnicity (OR, 0.72; 95% CI, 0.53-0.97), estimated fetal weight centile (OR, 1.01; 95% CI, 1.00-1.02) and CPR MoM (OR, 0.24; 95% CI, 0.12-0.47). Conclusion Pregnancies complicated by multiple episodes of RFM show significantly lower CPR MoM and MCA-PI MoM compared with those with single episodes and controls. This is likely to be due to worsening fetal hypoxemia in women presenting with recurrent RFM. Copyright (c) 2017 ISUOG. Published by John Wiley & Sons Ltd.

Datos de la publicación

ISSN/ISSNe:
0960-7692, 1469-0705

ULTRASOUND IN OBSTETRICS & GYNECOLOGY  WILEY-BLACKWELL

Tipo:
Article
Páginas:
375-380
Factor de Impacto:
3,155 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 19

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Keywords

  • cerebroplacental ratio; Doppler ultrasound; fetal hypoxemia; reduced fetal movements

Campos de estudio

Proyectos asociados

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

PAPEL DEL FACTOR DE CRECIMIENTO PLACENTARIO EN EL MANEJO DE LA PREECLAMPSIA NO SEVERA: ESTUDIO ALEATORIZADO

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

PI15/01935 . INSTITUTO DE SALUD CARLOS III . 2016

Iplacenta. innovation in pacenta modelling for maternal and fetal health.

Investigador Principal: JOSÉ MORALES ROSELLÓ

765274 . COMISION EUROPEA . 2018

ENSAYO MULTICÉNTRICO, ABIERTO, ALEATORIZADO, DE DOSIS ÚNICA, CONTROLADO, DE XOMA 213 ADMINISTRADO POR VÍA INTRAVENOSA A MUJERES DESPUÉS DEL PARTO PARA LA SUPRESIÓN DE LA LACTANCIA.

Investigador Principal: ALFREDO JOSÉ PERALES MARÍN

X213220

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