Doppler evaluation of the posterior cerebral artery in normally grown and growth restricted fetuses

Benavides‐Serralde, J. A.; Hernández‐Andrade, Edgar; Cruz‐Martínez, R.; Cruz‐Lemini, M.; Scheier, M.; Figueras, F.; Mancilla, Javier; Gratacós, Eduard

doi:10.1002/pd.4265

Cited by 11 publications

(11 citation statements)

References 33 publications

(61 reference statements)

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“… 9 explored the MCA and two segments of the ACA in IUGR fetuses and observed that the first segment of the ACA exhibited a reduced PI earlier than the MCA. In terms of PCA-PI, other teams 10 , 11 have reported that IUGR fetuses showed vasodilatation in the PCA earlier than in the MCA regardless of the UA-PI value. However, our study showed that there was no difference between MCA and PCA vasodilatation in the CHD fetuses.…”

Section: Discussionmentioning

confidence: 93%

“…Differences in head biometrics and cerebral artery PIs were analyzed by a one-way analysis of variance (ANOVA) with post hoc Games-Howell testing. Signs of fetal cerebral vasodilatation were present when cerebral artery PIs were below the 5th percentile 11 , 24 , 25 . Cases with cerebral vasodilatation were recorded and compared in terms of the ACA, MCA and PCA in each CHD subgroup using χ 2 tests.…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have demonstrated the existence of regional brain redistribution processes. Both the anterior cerebral artery (ACA) 9 , 10 and the posterior cerebral artery (PCA) 11 present earlier signs of vasodilatation than the MCA in fetuses with intrauterine growth restriction (IUGR). Dubiel M. et al .…”

Section: Introductionmentioning

confidence: 99%

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Different vasodilatation characteristics among the main cerebral arteries in fetuses with congenital heart defects

Peng

Zeng

Zhou

et al. 2018

Sci Rep

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To observe Doppler changes in the three main cerebral arteries in fetuses with congenital heart defects (CHDs). The pulsatility index (PI) values of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) were prospectively compared in 78 CHD fetuses and 78 normal control fetuses. Correlations between the cerebral artery PIs and the neurodevelopment scores (psychomotor development index [PDI] and mental development index [MDI]) were assessed. The MCA-PI was decreased significantly in fetuses with hypoplastic left heart syndrome (HLHS). The ACA-PI was reduced significantly in fetuses with HLHS, fetuses with left-sided obstructive lesions (LSOLs) and fetuses with transposition of the great arteries. The PCA-PI was significantly smaller in fetuses with HLHS and fetuses with LSOLs. More fetuses presented signs of cerebral vasodilatation of the ACA than the MCA for certain types of CHD (P < 0.05). The ACA-PI was positively correlated with the PDI and MDI scores in fetuses with CHDs (r2 = 0.26, 0.20, P < 0.01). The MCA-PI was only positively correlated with the PDI scores (r2 = 0.15, P < 0.01). The ACA exhibited signs of vasodilatation more frequently and severely than the MCA. The ACA-PI appears to be more sensitive for predicting abnormal neurodevelopmental outcomes than the MCA-PI.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

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Different vasodilatation characteristics among the main cerebral arteries in fetuses with congenital heart defects

Peng

Zeng

Zhou

et al. 2018

Sci Rep

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“…The MCA PI was measured distal to the circle of Willis in the proximal third of the vessel. In the same plane as the MCA, the first segment of the ACA (S1) was assessed just distal to its origin from the internal carotid artery 18 and the second segment of the PCA (S2) was assessed distal to the junction with the posterior communicating artery 19 . The vertebral artery was identified between the occipital bone and the first cervical vertebra using colour Doppler in the nuchal region 20 .…”

Section: Methodsmentioning

confidence: 99%

Feto‐placental Dopplers are not altered in women with obstructive sleep apnoea symptoms

Robertson

Okano

Kumar

2020

Aust NZ J Obst Gynaeco

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Background: Snoring, gasping or choking during sleep are common symptoms of sleep-disordered breathing and are associated with multiple adverse maternal and obstetric outcomes. The mechanisms responsible remain unknown; however, placental dysfunction is suspected. Aims: The aim of this study was to investigate feto-placental and fetal cardiac function in women with pregnancies complicated by obstructive sleep apnoea symptoms. Materials and methods: This was a prospective observational cohort study at a large tertiary obstetric hospital in Australia. Women were asked to complete a questionnaire relating to the presence and severity of obstructive sleep apnoea symptoms. They also underwent an ultrasound scan where Doppler indices of various feto-placental vessels and fetal cardiac function were measured. Regional cerebral perfusion was also assessed. Results: A total of 255 women were included in the final analysis. Of these, 36.1% (92/255) of women reported no obstructive sleep apnoea symptoms; 63.9% (163/255) reported they experienced some form of obstructive sleep apnoea symptoms that included any frequency of snoring or choking/gasping, while 42.0% (107/255) complained of severe obstructive sleep apnoea symptoms (snoring ≥ 3 times a week or choking/gasping). There were no significant differences in fetoplacental Dopplers or fetal cardiac function parameters in women with obstructive sleep apnoea symptoms. There were also no differences in regional cerebral blood flow between groups, or any correlation with severity of symptoms. Conclusions: Our data challenge the current perspective that adverse perinatal outcomes in women with obstructive sleep apnoea symptoms are related primarily to placental dysfunction and fetal compromise.

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“…We read with interest the article by Benavides‐Serralde et al ,. who conclude that brain sparing is an earlier phenomenon in the posterior cerebral artery (PCA) than in the middle cerebral artery (MCA) Doppler changes.…”

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confidence: 99%

Comment on “Doppler evaluation of the posterior cerebral artery in normally grown and growth restricted fetuses”

et al. 2014

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Doppler evaluation of the posterior cerebral artery in normally grown and growth restricted fetuses

Abstract: In IUGR fetuses, the two segments of the PCA show signs of vasodilatation earlier than the MCA. As IUGR fetuses deteriorate, the two segments of the PCA and the MCA behave similarly.

Cited by 11 publications

References 33 publications

Different vasodilatation characteristics among the main cerebral arteries in fetuses with congenital heart defects

Different vasodilatation characteristics among the main cerebral arteries in fetuses with congenital heart defects

Feto‐placental Dopplers are not altered in women with obstructive sleep apnoea symptoms

Comment on “Doppler evaluation of the posterior cerebral artery in normally grown and growth restricted fetuses”

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