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J Perinatol ; 38(5): 474-481, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29410542

RESUMO

OBJECTIVE: Determine if abnormal prenatal Doppler ultrasound indices are predictive of postnatal impaired cerebral autoregulation. STUDY DESIGN: Prospective cohort study of 46 subjects, 240-296 weeks' gestation. Utilizing near-infrared spectroscopy and receiver-operating characteristic analysis, impaired cerebral autoregulation was defined as >16.5% time spent in a dysregulated state within 96 h of life. Normal and abnormal Doppler indices were compared for perinatal outcomes. RESULTS: Subjects with abnormal cerebroplacental ratio (n = 12) and abnormal umbilical artery pulsatility index (n = 13) were likely to develop postnatal impaired cerebral autoregulation (p ≤ 0.02). Abnormal cerebroplacental ratio was associated with impaired cerebral autoregulation between 24 and 48 h of life (p = 0.016). These subjects have increased risk for fetal growth restriction, lower birth weight, lower Apgar scores, acidosis, and severe intraventricular hemorrhage and/or death (p < 0.05). CONCLUSION: Abnormal cerebroplacental ratio and umbilical artery pulsatility index are associated with postnatal impairment in cerebral autoregulation and adverse outcome.


Assuntos
Cérebro/fisiopatologia , Doenças Fetais/diagnóstico por imagem , Artéria Cerebral Média/diagnóstico por imagem , Fluxo Pulsátil , Artérias Umbilicais/diagnóstico por imagem , Adulto , Peso ao Nascer , Artérias Cerebrais/fisiopatologia , Feminino , Doenças Fetais/prevenção & controle , Idade Gestacional , Homeostase , Humanos , Recém-Nascido , Valor Preditivo dos Testes , Gravidez , Estudos Prospectivos , Curva ROC , Ultrassonografia Doppler , Ultrassonografia Pré-Natal , Artérias Umbilicais/fisiopatologia
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