title: The predictive value of lactate peak detected by the magnetic resonance spectroscopy in the brain of growth-restricted fetuses for adverse perinatal outcomes.
abstract: To compare perinatal outcomes between patients with and without abnormal Doppler findings and lactate peak in the fetal brain detected by magnetic resonance spectroscopy ((1)HMRS) and to assess the feasibility of fetal brain lactate in the prediction of adverse obstetric outcomes in growth-restricted fetuses.
  
  
  
  Pregnancies with FGR fetuses underwent Doppler ultrasonography and 3 Tesla (1)HMRS for the presence of lactate peak prior to the delivery. Patients were assigned into the following groups; normal Doppler, no lactate peak (Group 1), normal Doppler, lactate peak (+) (Group II), abnormal Doppler, no lactate peak (Group III), abnormal Doppler, lactate peak (+) (Group IV).
  
  
  
  Five perinatal deaths, all in Group IV, were encountered (p < 0.001). Perinatal death rate was higher in patients with Doppler flow abnormality ((5/12 (41.7%)) than in patients without Doppler abnormality (0/23) (p < 0.001) and was significantly higher in the presence (5/18 (27.8%)) than in the absence of lactate peak (0/17) (p = 0.019).
  
  
  
  Fetuses with brain lactate peak detected by (1)HMRS in addition to altered Doppler findings are more likely to develop short-term morbidities and perinatal death. Fetal brain lactate detected by (1)HMRS may represent a clinical marker of altered brain metabolism and further perinatal complications.
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey .
authors.forename: Emek
authors.initials: E
authors.lastname: Doğer
authors.affiliation: b Department of Obstetrics and Gynecology , Gölcük Military Hospital , Kocaeli , Turkey , and.
authors.forename: Özkan
authors.initials: Ö
authors.lastname: Özdamar
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey .
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Çakıroğlu
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey .
authors.forename: Yasin
authors.initials: Y
authors.lastname: Ceylan
authors.affiliation: c Department of Radiology , School of Medicine, Kocaeli University , Kocaeli , Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Çakır
authors.affiliation: c Department of Radiology , School of Medicine, Kocaeli University , Kocaeli , Turkey.
authors.forename: Yonca
authors.initials: Y
authors.lastname: Anık
authors.affiliation: a Department of Obstetrics and Gynecology , School of Medicine, Kocaeli University , Kocaeli , Turkey .
authors.forename: Eray
authors.initials: E
authors.lastname: Çalışkan
mesh_terms: D000328:Adult; D001921:Brain / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000378:metabolism; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000378:metabolism / Q000473:pathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017078:Laser-Doppler Flowmetry; D009682:Magnetic Resonance Spectroscopy; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome; D016037:Single-Blind Method; D016216:Ultrasonography, Prenatal; D055815:Young Adult
keywords: Fetal growth restriction; lactate; magnetic resonance spectroscopy; perinatal death