title: Fetal cerebral and umbilical Doppler in pregnancies complicated by late-onset placental abruption.
abstract: OBJECTIVE
  To evaluate whether changes in the cerebroplacental Doppler and birth weight (BW) suggestive of chronic fetal hypoxemia, precede the development of late-onset placental abruption (PA) after 32 weeks.
  
  
  METHODS
  In a multicenter retrospective study, the Doppler examinations of the fetal umbilical artery (UA) and middle cerebral artery (MCA) recorded after 32 weeks were collected in pregnancies subsequently developing PA. The BW centiles were calculated and the MCA pulsatility indices (PI), and UA PI were converted into multiples of the median (MoM). Afterwards, a comparison was made with a group of fetuses, which did not develop PA. Logistic regression was used to adjust for potential confounders and evaluate the feasibility of the prediction model.
  
  
  RESULTS
  Pregnancies complicated by late-onset PA (n = 31) presented lower MCA PI (p = 0.015) and were smaller (p < 0.001) than those who did not (n = 1294). Logistic regression analysis indicated that cerebral vasodilation was more important than umbilical flow in the explanation of PA (MCA PI OR = 0.106, p = 0.014 and UA PI OR 1.901, p = 0.32). In addition, the influence of BW exerted was residual (BW centile OR = 0.989, p = 0.15).
  
  
  CONCLUSIONS
  Fetuses developing late-onset PA demonstrate significant cerebral vasodilation with scarce placental dysfunction, suggesting the existence of some kind of chronic hypoxemia that follows the late-onset pattern.
authors.affiliation: a Servicio de Obstetricia , Hospital Universitario y Politécnico La Fe , Valencia , Spain.
authors.forename: José
authors.initials: J
authors.lastname: Morales-Roselló
authors.affiliation: b Fetal Medicine Unit, St George's Hospital , London , UK.
authors.forename: Asma
authors.initials: A
authors.lastname: Khalil
authors.affiliation: a Servicio de Obstetricia , Hospital Universitario y Politécnico La Fe , Valencia , Spain.
authors.forename: Farida
authors.initials: F
authors.lastname: Akhoundova
authors.affiliation: c Dipartimento di Ostetricia , Ginecologia e Pediatria, Università Cattolica del Sacro Cuore , Rome , Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Salvi
authors.affiliation: d Dipartimento di Neuroscienze , Scienze Riproduttive ed Odontostomatologiche, Unità di Gravidanza a Rischio e Diagnosi Prenatale, Università degli Studi di Napoli Federico II , Naples , Italy.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Morlando
authors.affiliation: b Fetal Medicine Unit, St George's Hospital , London , UK.
authors.forename: Janani
authors.initials: J
authors.lastname: Sivanathan
authors.affiliation: a Servicio de Obstetricia , Hospital Universitario y Politécnico La Fe , Valencia , Spain.|e Grupo Bioelectrónica (I3BH) , Universidad Politécnica , Valencia , Spain , and.
authors.forename: José
authors.initials: J
authors.lastname: Alberola-Rubio
authors.affiliation: f Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe , Valencia , Spain.
authors.forename: David
authors.initials: D
authors.lastname: Hervas-Marín
authors.affiliation: f Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe , Valencia , Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Fornés-Ferrer
authors.affiliation: a Servicio de Obstetricia , Hospital Universitario y Politécnico La Fe , Valencia , Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Perales-Marín
authors.affiliation: b Fetal Medicine Unit, St George's Hospital , London , UK.
authors.forename: Basky
authors.initials: B
authors.lastname: Thilaganathan
mesh_terms: D000037:Abruptio Placentae / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000328:Adult; D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005333:Fetus / Q000098:blood supply* / Q000000981:diagnostic imaging; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D011247:Pregnancy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Fetal middle cerebral artery Doppler; late-onset fetal growth restriction; placental abruption; umbilical artery Doppler