title: Assessment of motoric and hemodynamic parameters in growth restricted fetuses - case study.
abstract: OBJECTIVE
  In order to more accurately assess fetal neurological status in five fetuses with severe intrauterine growth restriction (IUGR), combined assessment of their hemodynamics and motor activity was undertaken in this study.
  
  
  METHODS
  Hemodynamic changes in the placental and fetal cerebral vessels were evaluated using the umbilical artery resistance index (URI), and the middle cerebral artery resistance index (CRI). The blood flow redistribution towards the fetal brain in response to fetal hypoxia was detected by the C/U (cerebro - umbilical) ratio, expressed as CRI/URI. Motoric parameters were assessed by new antenatal neurologic scoring test named Kurjak Antenatal Neurodevelopmental Test (KANET), based on evaluation of spontaneous motor activity using four-dimensional (4D) ultrasound.
  
  
  RESULTS
  KANET has potential in recognizing pathologic and borderline behavior in IUGR fetuses with or without blood flow redistribution towards the fetal brain. Very low values of C/U ratio and abnormal KANET score have indicated adverse pregnancy outcome.
  
  
  CONCLUSIONS
  In some pregnancies complicated with IUGR, estimation of the risk of hypoxia versus prematurity can be extremely puzzling. Combined assessment of hemodynamic and motoric parameters in IUGR fetuses could allow construction of an algorithm, which would be helpful in the decision making process of pregnancy termination.
authors.affiliation: Department of Obstetrics and Gynecology, Clinical Hospital Sveti Duh, Medical School, University of Zagreb , Zagreb , Croatia .
authors.forename: Maja
authors.initials: M
authors.lastname: Predojević
authors.forename: Amira
authors.initials: A
authors.lastname: Talić
authors.forename: Milan
authors.initials: M
authors.lastname: Stanojević
authors.forename: Asim
authors.initials: A
authors.lastname: Kurjak
authors.forename: Aida
authors.initials: A
authors.lastname: Salihagić Kadić
mesh_terms: D003661:Decision Support Techniques; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005311:Fetal Hypoxia / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009043:Motor Activity; D011247:Pregnancy; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*