Objective. The purpose of this study was to evaluate the changes in Doppler blood flow velocity (BFV) in cerebral and visceral arteries during infancy. Methods. The BFV was measured in 37 healthy term neonates in the anterior cerebral artery (ACA), middle cerebral artery (MCA), basilar artery, internal carotid artery (ICA), celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA). Results. The mean BFV increased and the resistive index decreased (P < .05) in all cerebral arteries, SMA, and CA by the age of 12 to 23.9 hours and in the RA by the age of 24 to 35.9 hours compared with 2 to 11.9 hours. A further significant increase (P < .05) of the mean BFV occurred in all arteries except the ICA and CA by the age of 72 to 120 hours compared with 12 to 23.9 hours. By the age of 21 to 59 days, the mean BVF doubled in all investigated arteries compared with 2 to 11.9 hours, with a further significant increase (P < .05) by the age of 150 to 240 days in cerebral and renal arteries. There was no correlation between the mean blood pressure (BP) and mean BFV in the ACA and MCA. However, there was a positive correlation (r ≥ 0.5; P < .05) between the BP and BFV in the RA and SMA at the age of 12 to 23.9 hours. Conclusions. A significant increase in the cerebral and visceral BFV occurs normally throughout infancy, with the visceral BFV affected by BP changes during the first day of life. Key words: cerebral blood flow velocity; neonate; sonography; visceral blood flow velocity. oppler sonography is a noninvasive method that allows repeated and safe assessment of hemodynamics in neonatal units. Several studies have shown that a pulsed Doppler technique can be used to examine the pattern of blood flow velocity (BFV) in major vessels of the brain 1 as well as visceral organs 2 in neonates with good reproducibility. Several studies have followed the BFV in different cerebral 3-6 and visceral 7-11 arteries during cardiovascular adaptation of the neonate within the first week of life. These studies typically evaluated a single organ. A few cross-sectional studies have followed the changes of the cerebral BFV in neonates up to the first 20 days of life 12 and infants older than 30 days. 13,14 Cross-sectional studies of the BFV in renal arteries have also been performed in infants older than 30 days. 7,[15][16][17] To our knowledge there have been no studies looking at the normal preprandial splanchic BFV in infants older than 1 month.

The purpose of this study was to establish the first-trimester screening for Down syndrome (DS) in Estonia and to evaluate the potential of a contingent screening in the population of pregnant women. A prospective cohort study included non-selected pregnancies during the programme of first-trimester screening for DS in a 4-year period at a single centre. The following screening tests were evaluated: measurement of nuchal translucency (NT) and serum screening [pregnancy-associated plasma protein A and free beta subunit of human chorionic gonadotropin (fβ-HCG)]; results were given as combined screening. After first-trimester screening, contingent screening protocol was used, and women were divided into three groups: high risk, low risk and an intermediate risk group. In the last group, a second-trimester triple test (AFP; total HCG and uE3) was also performed. The study group consisted of 3,194 non-selected pregnancies. In 1,387 (43.4%) women, first-trimester serum screening showed low risk (risk ≤ 1:5,000), and no future testing was performed, in 30 (0.9%) women screening test showed high risk (risk≥1:50) and a diagnostic test was offered, and in 1,777 (55.7%) women repeated risk calculation in the second trimester was done. During the study period, there were 17 cases of trisomy 21, of which 15 (88.3%) were detected with the described screening programme. In conclusion, two-step contingent sequential screening is a better choice for Down syndrome screening in Estonia instead of previously used second-trimester screening, and it offers the advantage of earlier diagnosis.

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Objective: To investigate whether chromosomally normal fetuses with marked changes in maternal serum markers and first trimester ultrasound NT marker have an increased risk of congenital anomalies or delayed development at 2 years of age. Methods: Screening tests of 5257 pregnant women were analyzed during a one-year period. Significant changes in biochemical and/or ultrasound markers were documented in 138 pregnant women, whereas positive risk calculation for chromosomal anomalies was evident in 74 of them, who were included in our study. Postnatal study group included 35 children born from mothers with marked changes in screening tests. Results: Among the 74 pregnant women, a structural or genetic abnormality was diagnosed in 16 cases (21.6%), fetal death occurred in 12 cases (16.2%) and child was healthy at the age of 2 years in 31 cases (41.9%). In 3/4 of the cases, a pathology was diagnosed prenatally, while the remaining 1/4 were discovered postnatally. Four children had with congenital anomalies and/or syndromes: two had congenital heart disease-atrial septal defect and ventricular septal defect with patent ductus arteriosus, one Silver-Russell syndrome and one congenital adrenal hyperplasia. It was not possible to get the final information about outcome in 15 cases (20.3%). Conclusions: Children born to these mothers should be actively followed by a pediatrician or clinical geneticist for additional investigations after birth as they have a risk of 5.4% of having a congenital or genetic abnormality.

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