Predictive value of critical disturbances in fetoplacental circulation in intrauterine growth restriction pregnancies


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To analyze the indicators of fetoplacental hemodynamics in intrauterine growth restriction (IUGR) pregnancies and to assess the effect of fetoplacental circulation on the neonatal outcome. Materials and methods. The analysis of data was based on 138 birth records of women with IUGR who delivered infants with a weight less than 2000g. Results. The evaluation of the perinatal outcomes and their correlation with the disturbances of fetoplacental circulation revealed that the risk of neonatal death is three times higher if there are severe disturbances in fetoplacental hemodynamics. Conclusion. The results of the study have demonstrated the significance of regular ultrasound Doppler evaluation of fetoplacental circulation in IUGR pregnancies in order to control intrauterine fetal condition and improve perinatal outcomes.

Full Text

Restricted Access

About the authors

Natalia B. Kuznetsova

Rostov State Medical University, Ministry of Health of Russia

Email: lauranb@inbox.ru
Doctor of Medical Sciences, Professor at the Department of Simulation education

Irina O. Bushtyrova

Clinic of Professor Bushtyreva LLC

Email: kio4@mail.ru
Doctor of Medical Sciences, Full Professor.

Ekaterina A. Zabanova

Rostov State Medical University, Ministry of Health of Russia; Rostov Regional Perinatal Center

Email: rock-fe@mail.ru
Postgraduate at the Department of Simulation education

Victoria V. Barinova

Rostov State Medical University, Ministry of Health of Russia; Clinic of Professor Bushtyreva LLC; Rostov Regional Perinatal Center

Email: victoria-barinova@yandex.ru
Candidate of Medical Sciences, Assistant of the Department of Obstetrics and Gynecology №1

Anna V. Gugueva

Rostov Regional Perinatal Center

Email: anna-gugueva@mail.ru
obstetrician-gynecologist, State Budgetary Institution

References

  1. Стрижаков А.Н., Игнатко И.В., Тимохина Е.В., Белоцерковцева Л.Д. Синдром задержки роста плода: патогенез, диагностика, лечение, акушерская тактика. М.: ГЭОТАР-Медиа; 2014. 120 с. [Strizhakov A. N., Ignatko I. V., Timokhina E. V., Belotserkovtseva L. D. Fetal growth retardation. Pathogenesis, diagnosis, treatment, obstetric tactics. Moscow: GEOTAR-Media; 2014. (in Russian)].
  2. Unterscheider J., Daly S., Geary M.P., Kennelly M.M., Mc Auliffe F.M., O’Donoghue K. et al. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study. Am. J. Obstet. Gynecol. 2013; 208(4): 290. e1-6. https://dx.doi.org/10.1016/j.ajog.2013.02.007.
  3. Figueras F., Gratacos E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn. Ther. 2014; 36(2): 86-98. https://dx.doi.org/10.1159/000357592.
  4. Gordijn S.J., Beune I.M., Ganzevoort W. Building consensus and standards in fetal growth restriction studies. Best Pract. Res. Clin. Obstet. Gynaecol. 2018; 49: 117-26. https://dx.doi.org/10.1016/j.bpobgyn.2018.02.002.
  5. Serena C., Marchetti G., Rambaldi M.P., Ottanelli S., Di Tommaso M., Avagliano L. et al. Stillbirth and fetal growth restriction. J. Matern. Fetal Neonatal Med. 2013; 26(1): 16-20. https://dx.doi.org/10.3109/14767058.201 2.718389.
  6. Gardosi J., Madurasinghe V., Williams M., Malik A., Francis A. Maternal and fetal risk factors for stillbirth: population based study. BMJ. 2013; 346: f108. https:// dx.doi.org/10.1136/bmj.f108.
  7. American College of Obstetricians and Gynecologists. ACOG Practice bulletin No. 134: fetal growth restriction. Obstet. Gynecol. 2013; 121(5): 1122-33. https://dx.doi.org/10.1097/01.AOG.0000429658.85846.f9.
  8. Mendez-Figueroa H., Truong V.T., Pedroza C., Khan A.M., Chauhan S.P Small-for-gestational-age infants among uncomplicated pregnancies at term: a secondary analysis of 9 Maternal-Fetal Medicine Units Network studies. Am. J. Obstet. Gynecol. 2016; 215(5):628. e1-628. e7. https://dx.doi.org/10.1016/j. ajog.2016.06.043.
  9. Malhotra A., Allison B.J., Castillo-Melendez M., Jenkin G., Polglase G.R., Miller S.L. Neonatal morbidities of fetal growth restriction: pathophysiology and impact. Front. Endocrinol. (Lausanne). 2019; 10: 55. https://dx.doi. org/10.3389/fendo.2019.00055.
  10. Lio A, Rosati P., Pastorino R., Cota F., Tana M., Tirone C. et al. Fetal Doppler velocimetry and bronchopulmonary dysplasia risk among growth-restricted preterm infants: an observational study. BMJ Open. 2017; 7(7): e015232. https://dx.doi.org/10.1136/bmjopen-2016-015232.
  11. Афанасьева Н.В., Стрижаков А.Н. Исходы беременности и родов при фетоплацентарной недостаточности различной степени тяжести. Вопросы гинекологии, акушерства и перинатологии. 2004; 3(2): 7-13. [Afanasyeva N.V., Strizhakov A.V. Outcomes of pregnancy and childbirth with fetoplacental insufficiency of various severity. Problems of Gynecology, Obstetrics and Perinatology. 2004; 3(2): 7-13. (in Russian)].
  12. Katz J., Lee A.C., Kozuki N., Lawn J.E., Cousens S., Blencowe H. et al. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: a pooled country analysis. Lancet. 2013; 382(9890): 417-25. https://dx.doi.org/10.1016/S0140-6736(13)60993-9.
  13. Cohen E., Baerts W, van Bel F. Brain-sparing in intrauterine growth restriction: considerations for the neonatologist. Neonatology. 2015; 108(4): 269-76. https://dx.doi.org/10.1159/000438451.
  14. Baschat A.A. Neurodevelopment after fetal growth restriction. Fetal Diagn. Ther. 2014; 36(2): 136-42. https://dx.doi.org/10.1159/000353631.
  15. Leitner Y., Fattal-Valevski A., Geva R., Eshel R., Toledano-Alhadef H., Rotstein M. et al. Neurodevelopmental outcome of children with intrauterine growth retardation: a longitudinal, 10-year prospective study. J. Child Neurol. 2007; 22(5): 580-7. https://dx.doi.org/10.1177/0883073807302605.
  16. Barker D.J. In utero programming of chronic disease. Clin. Sci. (Lond.). 1998; 95(2): 115-28.
  17. Colella M., Frerot A., Novais A.R.B., Baud O. Neonatal and long-term consequences of fetal growth restriction. Curr. Pediatr. Rev. 2018; 14(4): 212-8. https://dx.doi.org/10.2174/1573396314666180712114531.
  18. Ojeda N.B., Grigore D., Alexander B.T. Intrauterine growth restriction: fetal programming of hypertension and kidney disease. Adv. Chronic Kidney Dis. 2008; 15(2): 101-6. https://dx.doi.org/10.1053/j.ackd.2008.01.001.
  19. Crispi F., Crovetto F., Gratacos E. Intrauterine growth restriction and later cardiovascular function. Early Hum. Dev. 2018; 126: 23-7. https:// dx.doi.org/10.1016/j.earlhumdev.2018.08.013.
  20. Tru dinger B.J., Cook C.M. Doppler umbilical and uterine flow waveforms in severe pregnancy hypertension. Br. J. Obstet. Gynaecol. 1990; 97(2): 142-8. https://dx.doi.org/10.1111/j.1471-0528.1990. tb01739.x.
  21. Hecher K., Bilardo C.M., Stigter R.H., Ville Y., Hackeloer B.J., Kok H.J. et al. Monitoring of fetuses with intrauterine growth restriction: a longitudinal study. Ultrasound Obstet. Gynecol. 2001; 18(6): 564-70. https://dx.doi.org/10.1046/ j.0960-7692.2001.00590.x.
  22. Hecher K., Snijders R., Campbell S., Nicolaides K. Fetal venous, intracardiac, and arterial blood flow measurements in intrauterine growth retardation: relationship with fetal blood gases. Am. J. Obstet. Gynecol. 1995; 173(1): 10-5. https:// dx.doi.org/10.1016/0002-9378(95)90161-2.
  23. Schwarze A., Gembruch U., Krapp M., Katalinic A., Germer U., Axt-Fliedner R. Qualitative venous Doppler flow waveform analysis in preterm intrauterine growth-restricted fetuses with ARED flow in the umbilical artery - correlation with short-term outcome. Ultrasound Obstet. Gynecol. 2005; 25(6): 573 9. https://dx.doi.org/10.1002/uog.1914
  24. Royal College of Obstetricians and Gynaecologists. The investigation and management of the small-for-gestational-age fetus. Green-Top Guideline No. 31. 2nd ed. 22.03.2013.
  25. New Zealand Maternal Fetal Medicine Network. Guideline for the management of suspected small for gestational age singleton pregnancies and infants after 34 wk’ gestation. New Zealand Maternal Fetal Medicine Network ; 2014.
  26. Institute of Obstetricians and Gynaecologists Royal College of Physicians of Ireland. Fetal growth restriction-recognition, diagnosis management. Clinical Practice Guideline No. 28. 2017.
  27. Vayssiere C., Sentilhes L., Ego A., Bernard C., Cambourieu D., Flamant C. et al. Fetal growth restriction and intra-uterine growth restriction: guidelines for clinical practice from the French College of Gynaecologists and Obstetricians. Eur. J. Obstet. Gynecol. Reprod. Biol. 2015; 193: 10-8. https://dx.doi. org/10.1016/j.ejogrb.2015.06.021.
  28. Fenton T.R., Kim J.H. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr. 2013; 13: 59. https://dx.doi. org/10.1186/1471-2431-13-59.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies