Objective: To explore corpus callosum (CC) developmental differences by ultrasound in late-onset small fetuses compared with adequate for gestational age (AGA) controls. Study Design: Ninety four small (estimated fetal weight <10th centile) and 71 AGA fetuses were included. Small fetuses were further subdivided into fetal growth restriction (IUGR, n = 64) and small for gestational age (SGA, n = 30) based on poor perinatal outcome factors, that is, birth weight <3rd centile and/or abnormal cerebroplacental ratio and/or uterine artery Doppler. The entire cohort was scanned to assess CC by transvaginal neurosonography obtaining axial, coronal and midsagittal images. CC length, thickness, total area and the areas after a subdivision in 7 portions were evaluated by semiautomatic software. Furthermore, the weekly average growth of the CC in each study group was calculated and compared. Results: Small fetuses showed significantly shorter (small fetuses: 0.49 vs. AGA: 0.52; p < 0.01) and smaller CC (1.83 vs. 2.03; p < 0.01) with smaller splenium (0.47 vs. 0.55; p < 0.01) compared to controls. The CC growth rate was also reduced when compared to controls. Changes were more prominent in small fetuses with abnormal cerebroplacental Doppler suggesting fetal growth restriction. Conclusions: Neurosonographic assessment of CC showed significantly altered callosal development, suggesting in-utero brain reorganization in small fetuses. This data support the potential value of CC assessment by US to monitor brain development in fetuses at risk.
Objectives: To evaluate corpus callosum (CC) morphometric and growth differences by neurosonography (NSG) in small fetuses compared to controls. Methods: 94 small fetuses with normal umbilical Doppler and 71 controls underwent a transvaginal NSG in the third trimester of pregnancy obtaining axial, coronal and mid-sagittal images. CC length, genu, body and splenium thickness, total area and the areas after a subdivision in 7 portions were blindly evaluated by semi-automatic delineation. Measurements were corrected by the cephalic index. CC differences were further explored subdividing the group of small fetuses in two groups: 1). Late intrauterine growth restriction (IUGR) defined as those with an estimated fetal weight <3rd centile and/or abnormal CPR and/or abnormal uterine artery Doppler; and 2) Small for gestational age (SGA) defined as those without these features. Comparisons were adjusted by gestational age at NSG, maternal smoking and body mass index. Finally, CC growth rate was compared between clinical groups. Results: Small fetuses showed significantly shorter (small fetuses: 0.49 vs. control: 0.52; p < 0.01) and smaller CC (1.83 vs. 2.03; p < 0.01) and smaller areas in all subdivisions particularly in the splenium (0.47 vs. 0.55; p < 0.01). These changes were more markedly present in late IUGR fetuses. Also, small fetuses presented lower CC growth rate when compared to controls. Conclusions: NSG assessment of CC showed a significantly altered callosal development in small fetuses, supporting the existence of in-utero brain reorganization. This data supports the potential role of CC assessment by US to monitor brain development in fetuses at risk.
OP21.11Fatty acid intake in pregnant women with placental insufficiency R.F. Saffioti, R.M. Nomura
University of Sao Paulo, Sao Paulo, BrazilObjectives: To analyze the dietary intake of energy, macronutrients and fatty acids(FA) of pregnant women with placental insufficiency, and to compare with pregnant women without this obstetric complication. Methods: A prospective cross-sectional study with following inclusion criteria: singleton pregnancy, fetus alive; above 26 weeks gestation; diagnosis of placental insufficiency characterized by abnormal umbilical artery Doppler (PI > 95p); absence of fetal abnormalities or diabetes, without omega n-3 supplementation. The maternal dietary intake was investigated by applying the food frequency questionnaire (FFQ) able to characterize maternal intake during the last 3 months. We analyzed the absolute values and the % of total energy value(TEV). Results: We included 21 pregnant women in the study group with placental insufficiency and 21 pregnant women in the control group. No difference was found in the median BMI (study group = 26.5 kg/m 2 , control group = 28.0 kg/m 2 , p = 0.563). The analysis of the FFQ demonstrated maternal intake of energy was significant higher in the group with placental insufficiency than control group (2002 kcal vs.1515 kcal, p = 0.021). With regard to the consumption of FA, there was a signif...
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