Fetal biophysical profile and cerebro-umbilical ratio in assessment of brain damage in growth restricted fetuses

Habek, Dubravko; Jugović, Domagoj; Hodek, Branko; Herman, Radoslav; Matičević, Anija; Habek, Jasna Čerkez; Pišl, Zoran; Salihagić, Aida

doi:10.1016/j.ejogrb.2003.09.039

Cited by 19 publications

(24 citation statements)

References 15 publications

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“…Placental insufficiency, which is responsible for IUGR and fetal hypoxia, is one of the most important factors. Fetal hypoxia has been proven to activate a range of biophysical, cardiovascular, endocrine, and metabolic responses [22] .…”

Section: Discussionmentioning

confidence: 99%

Role of Oxidative Stress in Intrauterine Growth Restriction

Bırı¹,

Bozkurt²,

Turp³

et al. 2007

Gynecol Obstet Invest

259

191

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Aims: The objectives of this study were to determine the role of oxidative stress in intrauterine growth restriction (IUGR) and to investigate the possible molecular mechanism(s) leading to oxidant stress in IUGR. Methods: Parameters of the oxidative and antioxidant system were evaluated in maternal plasma, umbilical cord blood, and placental tissue of pregnant women with IUGR fetuses. The same samples were obtained from women with normal pregnancies and were evaluated. Results: The results of this study indicate that while the levels of malondialdehyde (MDA) and xanthine oxidase (XO) were higher in maternal plasma, umbilical cord plasma, and placental tissues of the patients with IUGR when compared to the control group [MDA: 142.8 ± 18.0 vs. 86.4 ± 22.5 nmol/ml, 151.6 ± 25.8 vs. 93.3 ± 7.4 nmol/ml, and 0.72 ± 0.19 vs. 0.42 ± 0.09 nmol/mg protein, respectively (for all p < 0.0005); XO: 1.251 ± 0.674 vs. 0.20 ± 0.019 mIU/ml (p < 0.0005), 1.97 ± 0.73 vs. 0.237 ± 0.143 mIU/ml (p < 0.0005), and 0.023 ± 0.0012 vs. 0.012 ± 0.004 mIU/ml (p < 0.025), respectively], the levels of antioxidant potential were identified to be lower in maternal plasma, umbilical cord plasma, and placental tissues of the patients with IUGR: 63.3 ± 11.9 vs. 198.0 ± 31.9 U/ml (p < 0.0005), 32.6 ± 3.7 vs. 206.5 ± 27.1 U/ml (p < 0.0005), and 0.56 ± 0.23 vs. 1.16 ± 0.29 U/ml (p < 0.0005), respectively. On the other hand, the activities of adenosine deaminase of the IUGR patients were higher than those of the control group in maternal plasma (204.8 ± 103.5 vs. 115.6 ± 31.8 U/l, p < 0.01) and umbilical cord blood samples (584.2 ± 285.2 vs. 147.9 ± 44.8 U/l, p < 0.0005) which may suggest that oxidative stress has a role in IUGR. Moreover, an increased superoxide dismutase activity in maternal plasma (128.2 ± 37.4 vs. 88.8 ± 16.6 U/ml, p < 0.005) and cord blood (162.1 ± 37.0 vs. 116.6 ± 20.7 U/ml, p < 0.005) and an increased glutathione peroxidase activity in maternal plasma (1.83 ± 0.26 vs. 1.47 ± 0.31 IU/ml, p < 0.01) and placental tissue (0.007 ± 0.0015 vs. 0.003 ± 0.0012 IU/ml, p < 0.0005) were detected, while decreased catalase activities in cord blood (23,717 ± 3,538 vs. 16,397 ± 2,771 IU/ml, p < 0.0005) and placental tissue (47.2 ± 17.2 vs. 70.7 ± 11.3 IU/ml, p < 0.005) were identified in IUGR groups. Conclusions: In the light of the results of this study, it can be stated that the oxidative stress increases in patients with IUGR. Providing high-risk patients with an antioxidant may be useful in the prevention or treatment of IUGR, although it is a condition with no certain treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Role of Oxidative Stress in Intrauterine Growth Restriction

Bırı¹,

Bozkurt²,

Turp³

et al. 2007

Gynecol Obstet Invest

259

191

View full text Add to dashboard Cite

show abstract

“…Previous studies [4,23] were suggested where the FBP and C/U ratio could be used in the antenatal monitoring of growth-retarded fetuses and significantly predicted the perinatal outcome and neonatal neurosonography in newborns with IUGR. The application of new, advanced, imaging techniques like 3-and 4-dimensional sonography might improve our understanding of the prenatal neurodevelopmental events and possibly facilitate the development of diagnostic strategies for the early detection or prevention of brain dysfunctions and damage in combinations with hemodynamic Doppler sonography evaluation [15,24,25].…”

Section: Discussionmentioning

confidence: 99%

Doppler Cerebro-Umbilical Ratio and Fetal Biophysical Profile in the Assessment of Peripartal Cardiotocography in Growth-Retarded Fetuses

Habek

Salihagić²,

Jugović³

et al. 2007

Fetal Diagn Ther

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Objective: The aim of the study was to examine the value of the fetal biophysical profile (FBP) and the Doppler cerebro-umbilical ratio (C/U) in the assessment of peripartal cardiotocography (CTG) in growth-retarded fetuses. Methods: The prospective study included 58 pregnant women with singleton pregnancy from 28 to 42 weeks of gestation with clinically and ultrasonically verified late intrauterine growth retardation (IUGR). After assessment of the FBP, flow velocity waveforms from the umbilical and middle cerebral arteries were recorded and the C/U ratio was calculated. The C/U ratio and the FBP were assessed twice a week. The last peripartal CTG was used as an outcome parameter. Results: The FBP score was statistically significant when associated with peripartal CTG (p < 0.001). The mean value of the FBP was 7.77 ± 0.28 for infants with a normal peripartal CTG, 6.13 ± 0.41 for infants with a prepathological CTG and 4.40 ± 0.60 for infants with a pathological peripartal CTG. There was also a statistically significant association between the C/U ratio ≧1 and normal CTG (p < 0.005), but there was no statistically significant difference between prepathological and pathological CTG in relation to C/U ratio values (p > 0.05). Normal and pathological peripartal CTG was correlated with the perinatal outcome, but prepathological CTG was not correlated with results of the perinatal outcome (p > 0.05). Conclusions: Our results showed that both methods of fetal monitoring need to be used in perinatal monitoring of growth-retarded fetuses. The two methods can be used as important parameters in deciding to end pregnancies with IUGR when pathological values occur.

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“…The fetal CPR was shown to be a good predictor of adverse perinatal outcomes in post-term pregnancies and impaired neurological development in growth-restricted fetuses [17,[20][21][22] . Jain et al [23] investigated the utility of the CPR as a prognostic factor for adverse perinatal outcome and found that abnormal CPR was related to the prevalence of fetal distress, length of stay in the neonatal intensive care unit and intrauterine growth restriction.…”

Section: Discussionmentioning

confidence: 99%

The Value of the Cerebroplacental Ratio for the Prediction of Intrapartum Fetal Monitoring in Low-Risk Term Pregnancies

Liu

Song²,

Zhao³

et al. 2016

Gynecol Obstet Invest

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Aim: The study aimed to investigate the use of fetal cerebroplacental ratio (CPR) to identify fetuses at high risk before labor due to the brain sparing phenomenon. Materials and Methods: Four hundred and seventy-six singleton pregnancies were enrolled in this study. The CPR was recorded within 1 week of delivery and labor was managed according to local protocols and guidelines. Intrapartum and neonatal outcome details were recorded. Results: The CPR values of fetuses subsequently presenting category III intrapartum electronic fetal monitoring (EFM) or category II EFM without improvement (category IIB EFM) or with progression to category III (category IIC EFM) were significantly lower. On multivariate logistic regression, CPR was independently associated with the risk of categories III EFM, IIB EFM and IIC EFM. CPR was also a predictor of categories III EFM, IIB EFM and IIC EFM. Conclusions: Fetal CPR could be used to identify fetuses at high risk before labor and to help guide intrapartum management decisions.

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Fetal biophysical profile and cerebro-umbilical ratio in assessment of brain damage in growth restricted fetuses

Cited by 19 publications

References 15 publications

Role of Oxidative Stress in Intrauterine Growth Restriction

Role of Oxidative Stress in Intrauterine Growth Restriction

Doppler Cerebro-Umbilical Ratio and Fetal Biophysical Profile in the Assessment of Peripartal Cardiotocography in Growth-Retarded Fetuses

The Value of the Cerebroplacental Ratio for the Prediction of Intrapartum Fetal Monitoring in Low-Risk Term Pregnancies

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