title: The disappearing brain-sparing effect in early-onset fetal growth restriction fetuses revisited.
abstract: OBJECTIVE
  To evaluate the association between the brain-sparing situation and perinatal outcomes in fetuses with early-onset fetal growth restriction (EO-FGR) with absent or reverse end-diastolic flow in the umbilical artery (UA A/REDF).
  
  
  METHODS
  We evaluated fetuses with EO-FGR who had patterns of UA A/REDF without abnormal venous Doppler indices. Participants were divided into two groups according to measurements of mid-cerebral artery pulsatility index (MCA PI) just before delivery. Group 1 (n = 45) included those with a brain-sparing effect (BSE) (a MCA PI <5th percentile for the gestational age) and group 2 (n = 14) included those with a disappearing BSE, defined as an MCA PI increase towards normal values after the BSE detected at the initial evaluation. Short-term perinatal outcomes were analyzed.
  
  
  RESULTS
  Compared to group 1, group 2 had a significantly low birth weight (p = 0.018) and high rates of extended neonatal intensive care unit hospitalization (p = 0.049 respectively).
  
  
  CONCLUSIONS
  On the basis of longitudinal measurements of MCA PI, increases after the reduction <5th percentile might be related to poor perinatal outcomes in fetuses with EO-FGR who had UA A/REDF without abnormal venous flow patterns.
authors.affiliation: Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: A Özgür
authors.initials: AÖ
authors.lastname: Yeniel
authors.forename: A Mete
authors.initials: AM
authors.lastname: Ergenoglu
authors.forename: Cem Y
authors.initials: CY
authors.lastname: Sanhal
authors.forename: Ali
authors.initials: A
authors.lastname: Akdemir
authors.forename: Fuat
authors.initials: F
authors.lastname: Akercan
authors.forename: Mert
authors.initials: M
authors.lastname: Kazandi
authors.forename: Sermet
authors.initials: S
authors.lastname: Sagol
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply*; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055815:Young Adult