Nomograms of MPA and branch pulmonary artery diameters according to GA and EFW have been described, generating reference values.

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Despite the association verified by the univariate analysis between neonatal death and the parameters of fetal cerebral Doppler velocimetry, the multivariate analysis identified prematurity and degree of insufficiency of placental circulation as independent factors related to neonatal death in pregnancies complicated by placental insufficiency.

Methods:Weekly Dopplers are performed with the small-forgestational age fetuses with an estimated fetal weight below the 3rd percentile. We use biophysical profile score (BPS) in the management of them with normal UA Doppler indices. BPS 8 of 10 (abnormal fluid) and 6 of 10 (normal fluid) are fetal indications of deliver. Exclusion criteria were congenital malformations, birth weight above the 3rd percentile, delivery with maternal indications. All Doppler parameters ware transformed into Z-values according to published normal reference. UA, DV, AoI with values above the 95 th percentile ware considered abnormal. MCA-PI and CPR (cerebroplacental ratio) below the 5 th percentile were considered indicative of cerebral blood flow redistribution. CPR was calculated as the ratio MCA-PI:UA-PI. Perinatal adverse outcome was defined as death before hospital discharge, five minute Apgar score of less than 7, umbilical artery pH of less than 7.05, and intubation. Results: 5 fetuses evaluated. 3 of 5 were delivered in 37 and 38 weeks, because of lower BPS. 2 of 5 were spontaneous labor in 37 and 39 weeks. One was intubated, but otherwise there was no perinatal adverse outcome. All fetuses has cerebral blood flow redistribution. None of them have abnormal DV and AoI Doppler indices. 2 of them present AoI retrograde diastolic flow, but no perinatal adverse outcome was found. Conclusions: We could not find association of adverse perinatal outcome and MCA, DV and AoI Doppler indices of small-forgestational fetuses with both an estimated fetal weight below the 3rd percentile and normal umbilical arterial Doppler. Further research should be done. P08.08The relationship between first-trimester crown-rump length growth rate and birth weight

Short oral presentation abstracts midbody (p = 0.03) and splenium (p = 0.03) had a significant negative effect on the number of abnormal NBAS clusters. Conclusions: CC development was significantly altered in term SGA fetuses and correlated with worse neurobehavioral performance. CC could be further explored as a potential imaging biomarker to predict abnormal neurodevelopment in pregnancies at risk. OP25.06Cord blood biomarkers of brain injury in IUGR and correlation with fetal-placental Doppler values

The aim of this study was to determine the relation between fetal venous Doppler and acidemia at birth in pregnancies complicated by placental dysfunction before 34 weeks gestation. Methods: This was a prospective cohort study of 55 pregnancies with the diagnosis of placental dysfunction between 26 and 34 weeks of gestation. Inclusion criteria were singleton pregnancies, abnormal umbilical artery (UA) Doppler, intact membranes and absence of fetal congenital or chromosomal abnormalities. The following Doppler measurements were studied: UA pulsatility index (PI), ductus venosus (DV) pulsatility index for veins (PIV), intra-abdominal umbilical vein (UV) and left portal vein (LPV) time-averaged maximum velocity (TAMxV). Doppler exams were performed every 1 to 3 days. The last evaluation performed before delivery was analyzed. Acidemia at birth was defined as an umbilical artery pH below 7.20. Statistical analysis included Mann-Whitney-U test and the level of significance was set at P < 0.05. Results: Twenty-six newborns (48.1%) had acidemia at birth. Acidemic fetuses presented significantly lower UV-TAMx velocity than fetuses with normal pH at birth (0.81 ± 0.51 mL/min vs. 1.09 ± 0.54 mL/min, P = 0.04). The UA-PI was significantly increased in acidemic fetuses when compared with fetuses with normal pH at birth (2.93 ± 1.66 vs. 2.03 ± 0.96, P = 0.02). No difference was found in the analysis of other vessels. Conclusions: Placental dysfunction before 34 weeks of gestation is associated with low velocity flow in the intra-abdominal umbilical vein, that may be due to decreased cardiac function. Consideration of the clinical context and other cardiac and arterial Doppler parameters is important in distinguishing the pathophysiology of fetal response to hypoxia.

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