Normal reference ranges of fetal regional cerebral blood perfusion as measured by fractional moving blood volume

Cruz‐Martínez, R.; Figueras, F.; Hernández‐Andrade, Edgar; Benavides-Serralde, Andrés; Gratacós, Eduard

doi:10.1002/uog.7722

Cited by 23 publications

(21 citation statements)

References 32 publications

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“…We have demonstrated in this study that the regional perfusion of the basal ganglia is higher than the published foetal gestational age-based data [16], which is an expected result given that systemic blood flow is thought to increase after birth [17]. It is interesting to note that we did not demonstrate differences in FMBV between gestational age groups, whereas studies in the foetus show a weak positive correlation.…”

Section: Discussioncontrasting

confidence: 48%

Reference Ranges for Neonatal Basal Ganglia Perfusion as Measured by Fractional Moving Blood Volume

Schindler

Stevenson²,

Jayatilake³

et al. 2015

Neonatology

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Background: Regional changes in cerebral blood flow and perfusion are implicated in the pathogenesis of adverse neurological events that lead to death and severe disability in the newborn infant. The basal ganglia, in particular, are extremely sensitive to acute hypoxia in the perinatal period, but normal perfusion to this area is unknown. Objectives: To establish a reference range for regional basal ganglia perfusion using fractional moving blood volume (FMBV) as an index. Methods: Head ultrasounds were performed on neonates from 25 to 41 weeks' gestation. Power Doppler images were obtained from a pre-specified coronal plane. FMBV was calculated offline after selecting the basal ganglia as a region of interest. The average of five calculations was considered to be representative of the regional perfusion for each neonate. The data were analysed, and a neonatal reference range was defined. Results: 124 neonates were included in the study, and all had analysable data. The mean FMBV was 28.8% (±9.6) with a reference range defined as 10-48%. The mean FMBV for neonates <32 weeks', 32-35 weeks' and >35 weeks' gestation were 29.4% (±7.8), 29.2% (±11.0) and 27.4% (±9.7), respectively. Analysis of variance showed no significant difference between neonates based on gestation. Conclusions: We have successfully used the index FMBV to define a reference range for perfusion in the basal ganglia. These data can be used as a reference for subsequent studies that evaluate basal ganglia perfusion in pathological conditions.

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Section: Discussioncontrasting

confidence: 48%

Reference Ranges for Neonatal Basal Ganglia Perfusion as Measured by Fractional Moving Blood Volume

Schindler

Stevenson²,

Jayatilake³

et al. 2015

Neonatology

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“…Babies born to high-altitude hypertensive women weighed less at birth, were more often SGA and tended to have lower ponderal indices than those born to normal women at low or high altitude (table 2a). Early-versus late-onset PE pregnancies at high altitude more often delivered preterm (62% [5 and 95% CI ¼ 29, 96] versus 5% [24,14], p , 0.01) had greater fetal demise (38% [4,71] versus 0%, p , 0.05) and lower birth weight (1555 + 336 versus 2773 + 126 g, p , 0.01) but a similar frequency of SGA infants (50% [15,85] versus 48% [26,69], p ¼ n.s. ).…”

Section: (Iii) Newborn Characteristicsmentioning

confidence: 99%

Uterine artery blood flow, fetal hypoxia and fetal growth

Browne

Julian

Toledo-Jaldin

et al. 2015

Phil. Trans. R. Soc. B

115

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Evolutionary trade-offs required for bipedalism and brain expansion influence the pregnancy rise in uterine artery (UtA) blood flow and, in turn, reproductive success. We consider the importance of UtA blood flow by reviewing its determinants and presenting data from 191 normotensive (normal, n ¼ 125) or hypertensive ( preeclampsia (PE) or gestational hypertension (GH), n ¼ 29) Andean residents of very high (4100-4300 m) or low altitude (400 m, n ¼ 37). Prior studies show that UtA blood flow is reduced in pregnancies with intrauterine growth restriction (IUGR) but whether the IUGR is due to resultant fetal hypoxia is unclear. We found higher UtA blood flow and Doppler indices of fetal hypoxia in normotensive women at high versus low altitude but similar fetal growth. UtA blood flow was markedly lower in early-onset PE versus normal high-altitude women, and their fetuses more hypoxic as indicated by lower fetal heart rate, Doppler indices and greater IUGR. We concluded that, despite greater fetal hypoxia, fetal growth was well defended by higher UtA blood flows in normal Andeans at high altitude but when compounded by lower UtA blood flow in early-onset PE, exaggerated fetal hypoxia caused the fetus to respond by decreasing cardiac output and redistributing blood flow to help maintain brain development at the expense of growth elsewhere. We speculate that UtA blood flow is not only an important supply line but also a trigger for stimulating the metabolic and other processes regulating feto-placental metabolism and growth. Studies using the natural laboratory of high altitude are valuable for identifying the physiological and genetic mechanisms involved in human reproductive success.

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“…Qualitative variables are expressed as n (%). In order to make comparisons independent of the gestational age, all ultrasound parameters were converted into Z-scores using published normative data from a large population of healthy fetuses [21,30,31,32,33]. For multiple comparisons between the different subgroups of the study, we used one-way ANOVA with Bonferroni correction.…”

Section: Methodsmentioning

confidence: 99%

“…A complete ultrasound examination including fetal biometry (biparietal diameter, head circumference, abdominal circumference, femur length and estimated fetal weight) and fetoplacental Doppler [umbilical artery pulsatility index (PI), middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR) and brain frontal fractional moving blood volume (FMBV) [21]] were performed at 36-38 weeks of gestational age using a Voluson E8 (GE Medical, Waukesha, Wis., USA) or Siemens Sonoline Antares (Siemens Medical Systems, Malvern, Pa., USA) ultrasound machine equipped with a 9- to 2-MHz convex curved transducer [22]. …”

Section: Methodsmentioning

confidence: 99%

Severity of Fetal Brain Abnormalities in Congenital Heart Disease in Relation to the Main Expected Pattern of in utero Brain Blood Supply

et al. 2015

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Objectives: We evaluated the hypothesis that in fetuses with congenital heart disease (CHD) there is a correlation between the expected pattern of in utero brain blood supply and the severity of neurodevelopmental impairment. Methods: A total of 58 fetuses with CHD and 58 controls underwent a Doppler ultrasound and fetal MRI at 36-38 weeks. Fetuses with CHD were divided into two functional classes: class A with an expected severe reduction in oxygenated brain blood supply (left outflow tract obstruction and transposition of great vessels) and class B with theoretically near-normal or mildly impaired oxygenated brain blood supply (other CHD). Head biometry and cerebroplacental Doppler were assessed by ultrasound, and brain volumetry, cortical development and metabolism by MRI. Results: Both class A and B CHD fetuses had significant differences in head biometry, brain perfusion, cortical development and brain metabolism compared with controls. However, there was a significant linear tendency for head biometry, cerebral Doppler, volumes, cortical sulcation and metabolic ratios across the three clinical groups, with signs of more severe brain alterations in type A CHD fetuses. Conclusions: All fetuses with CHD showed significant brain developmental changes, but differences were more pronounced in CHD associated with an expected severe reduction in oxygenated blood supply to the brain.

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Normal reference ranges of fetal regional cerebral blood perfusion as measured by fractional moving blood volume

Cited by 23 publications

References 32 publications

Reference Ranges for Neonatal Basal Ganglia Perfusion as Measured by Fractional Moving Blood Volume

Reference Ranges for Neonatal Basal Ganglia Perfusion as Measured by Fractional Moving Blood Volume

Uterine artery blood flow, fetal hypoxia and fetal growth

Severity of Fetal Brain Abnormalities in Congenital Heart Disease in Relation to the Main Expected Pattern of in utero Brain Blood Supply

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