Steller Jon G, Gumina Diane, Driver Camille, Peek Emma, Galan Henry L, Reeves Shane, Hobbins John C
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO 80045, USA.
J Clin Med. 2022 Aug 1;11(15):4480. doi: 10.3390/jcm11154480.
Objective: Our objective was to compare differences in Doppler blood flow in four fetal intracranial blood vessels in fetuses with late-onset fetal growth restriction (FGR) vs. those with small for gestational age (SGA). Methods: Fetuses with estimated fetal weight (EFW) <10th percentile were divided into SGA (n = 30) and FGR (n = 51) via Delphi criteria and had Doppler waveforms obtained from the middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and vertebral artery (VA). A pulsatility index (PI) <5th centile was considered “abnormal”. Outcomes included birth metrics and neonatal intensive care unit (NICU) admission. Results: There were more abnormal cerebral vessel PIs in the FGR group versus the SGA group (36 vs. 4; p = 0.055). In FGR, ACA + MCA vessel abnormalities outnumbered PCA + VA abnormalities. All 8 fetuses with abnormal VA PIs had at least one other abnormal vessel. Fetuses with abnormal VA PIs had lower BW (1712 vs. 2500 g; p < 0.0001), delivered earlier (35.22 vs. 37.89 wks; p = 0.0052), and had more admissions to the NICU (71.43% vs. 24.44%; p = 0.023). Conclusions: There were more anterior vessels showing vasodilation than posterior vessels, but when the VA was abnormal, the fetuses were more severely affected clinically than those showing normal VA PIs.
我们的目的是比较晚发性胎儿生长受限（FGR）胎儿与小于胎龄儿（SGA）胎儿颅内四条血管的多普勒血流差异。方法：根据德尔菲标准，将估计胎儿体重（EFW）<第10百分位数的胎儿分为SGA组（n = 30）和FGR组（n = 51），并获取大脑中动脉（MCA）、大脑前动脉（ACA）、大脑后动脉（PCA）和椎动脉（VA）的多普勒波形。搏动指数（PI）<第5百分位数被认为“异常”。结局指标包括出生指标和新生儿重症监护病房（NICU）入院情况。结果：FGR组的脑血管PI异常比SGA组更多（36例对4例；p = 0.055）。在FGR中，ACA + MCA血管异常多于PCA + VA血管异常。所有8例VA PI异常的胎儿至少还有一条其他血管异常。VA PI异常的胎儿出生体重较低（1712对2500 g；p < 0.0001），分娩更早（35.22对37.89周；p = 0.0052），且NICU入院率更高（71.43%对24.44%；p = 0.023）。结论：显示血管舒张的前循环血管比后循环血管更多，但当VA异常时，胎儿在临床上比VA PI正常的胎儿受影响更严重。
