Longitudinal brain perfusion changes in near-term small-for-gestational-age fetuses as measured by spectral Doppler indices or by fractional moving blood volume.
OBJECTIVE
The objective of this study was to compare the temporal sequence of fetal brain hemodynamic changes in near-term small-for-gestational-age fetuses as measured by spectral Doppler indices or by fractional moving blood volume.


METHODS
Cerebral tissue perfusion measured by fractional moving blood volume, cerebroplacental ratio, anterior cerebral artery, and middle cerebral artery pulsatility indices were weekly performed in a cohort of singleton consecutive small-for-gestational-age fetuses with normal umbilical artery delivered after 37 weeks of gestation.


RESULTS
A total of 307 scans were performed on 110 small-for-gestational-age fetuses. Mean gestational age at diagnosis and at delivery was 35.7 and 38.6 weeks, respectively. The proportion of fetuses with abnormal fractional moving blood volume, cerebroplacental ratio, anterior cerebral artery-pulsatility index, and middle cerebral artery-pulsatility index values was 31.3%, 16.8%, 17.2%, and 10.8% at 37 weeks of gestation and 42.7%, 23.6%, 20.9%, and 16.4% before delivery.


CONCLUSIONS
The presence of brain redistribution in small-for-gestational-age fetuses was detected earlier and in a higher proportion of fetuses using cerebral tissue perfusion rather than spectral Doppler indices.
Cruz-Martinez
Rogelio
R
Department of Maternal-Fetal Medicine, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, University of Barcelona, Barcelona, Spain.
Figueras
Francesc
F
Hernandez-Andrade
Edgar
E
Puerto
Bienvenido
B
Gratacós
Eduard
E
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology*; D053208:Kaplan-Meier Estimate; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000502:physiology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011446:Prospective Studies; D018608:Ultrasonography, Doppler