Relationship between fetal Doppler indices and longterm outcome

There is a paucity of long-term neurological outcomes in high-risk pregnancies and few studies have looked at the predictive value of prenatal Doppler. Although abnormal UA Doppler waveforms are accurate predictors of adverse neonatal outcome, Wilson et al. (1992) found they were not predictive of long-term neurodevelopmental problems at 5 years of age. A larger study of women with severe pre-eclampsia also found no difference in Developmental Quotient at either 24 or 48 months in babies with normal or abnormal UA Doppler indices, although infants with AREDF in-utero scored lower in the performance subscale (Kirsten et al., 2000). Further follow-up is warranted to see whether this disadvantage persists. Unlike UA Doppler, fetal aortic waveforms have been shown to predict intellectual outcome at 2 years (Soothill et al., 1992) and impaired intellectual outcome at the age of 6—7 years (Ley et al., 1996).

With respect to the MCA, preterm fetuses with evidence of in-utero ''brain sparing'' have

Figure 32.3 Perinatal mortality and morbidity in relation to ductus venous Doppler. Summary of outcome data from studies of ductus venosus Doppler. Reproduced from Baschat (2004), with permission. Abbreviations: UA, umbilical artery; DV, ductus venosus; AREDF, absent/reversed end-diastolic frequencies; PIV, pulsatility index for veins; RDS, respiratory distress syndrome; BPD, bronchopulmonary dysplasia; NEC, necrotizing enterocolitis; IVH, intraventricular hemorrhage.

Figure 32.3 Perinatal mortality and morbidity in relation to ductus venous Doppler. Summary of outcome data from studies of ductus venosus Doppler. Reproduced from Baschat (2004), with permission. Abbreviations: UA, umbilical artery; DV, ductus venosus; AREDF, absent/reversed end-diastolic frequencies; PIV, pulsatility index for veins; RDS, respiratory distress syndrome; BPD, bronchopulmonary dysplasia; NEC, necrotizing enterocolitis; IVH, intraventricular hemorrhage.

accelerated neuronal maturation, as measured by visual evoked potentials, compared to gestation matched controls (Scherjon et al., 1996). At 2 years, fetal brain sparing seems a beneficial adaptation for neurological outcome (Chan et al., 1996; Scherjon et al., 1998). However, by 5 years it is associated with a lower cognitive outcome as evidenced by a 10-point reduction in mean IQ (Scherjon et al., 2000). No data are yet available on venous Doppler waveforms and long-term neurodevelopmental outcome.

Was this article helpful?

0 0
Diabetes Sustenance

Diabetes Sustenance

Get All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. This Book Is One Of The Most Valuable Resources In The World When It Comes To Learning How Nutritional Supplements Can Control Sugar Levels.

Get My Free Ebook


Post a comment