Department of Obstetrics and Gynecology, Fondazione Policlinico Tor Vergata, Università di Roma Tor Vergata, Rome, Italy.
Department of Obstetrics and Gynecology, Università di Chieti, Chieti, Italy.
J Perinat Med. 2024 Feb 1;52(4):423-428. doi: 10.1515/jpm-2023-0487. Print 2024 May 27.
To investigate midbrain growth, including corpus callusum (CC) and cerebellar vermis (CV) and cortical development in late fetal growth restricted (FGR) subclassified according to the umbilical vein blood flow (UVBF) values.
This was a prospective study on singleton fetuses late FGR with abnormal placental cerebral ratio (PCR). FGR fetuses were further subdivided into normal (≥fifth centile) and abnormal (<fifth centile) UVBF blood flow corrected for AC (UVBF/AC), neurosonography was performed at 33-34 weeks of gestation to assess CC and CV lengths and the depth of Sylvian fissure (SF), parieto-occipital (POF) and calcarine fissures (CF). Neurosonographic variables were normalized for fetal head circumference size.
The study cohort included 60 late FGR, 31 with normal UVBF/AC and 29 with abnormal UVBF/AC values. The latter group showed significant differences in CC (median (interquartile range (IQR) normal 0.96 (0.73-1.16) vs. abnormal UVBF/AC 0.60 (0.47-0.87); p<0.0001)), CV (normal 1.04 (0.75-1.26) vs. abnormal UVBF (AC 0.76 (0.62-1.18)); p=0.0319), SF (normal 0.83 (0.74-0.93) vs. abnormal UVBF/AC 0.56 (0.46-0.68); p<0.0001), POF (normal 0.80 (0.71-0.90) vs. abnormal UVBF/AC l 0.49 (0.39-0.90); p≤0.0072) and CF (normal 0.83 (0.56-1.01) vs. abnormal UVBF/AC 0.72 (0.53-0.80); p<0.029).
Late onset FGR fetuses with of reduced umbilical vein flow showed shorter CC and CV length and a delayed cortical development when compared to those with normal umbilical vein hemodynamics. These findings support the existence of a link between abnormal brain development and changes in umbilical vein circulation.
根据脐静脉血流（UVBF）值对晚期胎儿生长受限（FGR）进行亚分类，研究中脑生长情况，包括胼胝体（CC）和小脑蚓部（CV）以及皮质发育情况。
这是一项关于晚期胎盘脑比（PCR）异常的单胎胎儿生长受限（FGR）的前瞻性研究。FGR 胎儿进一步分为正常（≥第 5 百分位）和异常（<第 5 百分位）UVBF 血流校正后 AC（UVBF/AC），在妊娠 33-34 周时进行神经超声检查以评估 CC 和 CV 长度以及大脑外侧裂（SF）、顶枕叶（POF）和舌回裂（CF）的深度。神经超声变量按胎儿头围大小进行标准化。
该研究队列包括 60 例晚期 FGR，31 例 UVBF/AC 正常，29 例 UVBF/AC 值异常。后者组在 CC（中位数（四分位距（IQR）正常 0.96（0.73-1.16）与异常 UVBF/AC 0.60（0.47-0.87）；p<0.0001）、CV（正常 1.04（0.75-1.26）与异常 UVBF（AC 0.76（0.62-1.18）；p=0.0319）、SF（正常 0.83（0.74-0.93）与异常 UVBF/AC 0.56（0.46-0.68）；p<0.0001）、POF（正常 0.80（0.71-0.90）与异常 UVBF/AC l 0.49（0.39-0.90）；p≤0.0072）和 CF（正常 0.83（0.56-1.01）与异常 UVBF/AC 0.72（0.53-0.80）；p<0.029）方面存在差异。
与正常脐静脉血流动力学相比，脐静脉血流减少的晚期起病 FGR 胎儿 CC 和 CV 长度较短，皮质发育延迟。这些发现支持大脑发育异常与脐静脉循环变化之间存在联系。
