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OC11.01: Fetal hemodynamic assessment by MRI for detecting late‐onset intrauterine growth restriction ( IUGR )

2015; Wiley; Volume: 46; Issue: S1 Linguagem: Inglês

10.1002/uog.15018

1469-0705

Meng Yuan Zhu, Sarah Keating, Natasha Milligan, Rory Windrim, Sharon Portnoy, John G. Sled, Christopher K. Macgowan, John‏ Kingdom, Mike Seed,

Pregnancy and preeclampsia studies

To compare fetal hemodynamic measurements by Doppler and MRI in IUGR fetuses versus non-IUGR fetuses. Fetal body and brain weight, blood flow and oxygen saturations were measured using our previously published MRI technique1. Fetal O2 delivery (DO2) and consumption (VO2) were calculated using an estimated [Hb]2. We obtained MCA PI, UA PI and cerebroplacental ratio (CPR). IUGR patients were identified based on clinical data. The sensitivity and specificity of MRI and Doppler markers in IUGR detection were compared using ROC curves. 14 IUGR and 26 non-IUGR were studied at 35 weeks GA. IUGR fetuses had lower umbilical vein flow, pulmonary blood flow and higher SVC flow. Mean T2, fetal DO2 and VO2 were significantly lower in IUGR fetuses. There was no difference in UA PI. IUGR fetuses had lower MCA PI and CPR (P = 0.04, P = 0.004). ROC curves revealed equivalent sensitivity and specificity of MRI parameters for IUGR detection compared with Doppler parameters (figure 1). MRI confirmed the circulatory redistribution in response to hypoxia expected in IUGR fetuses. The reduced DO2 in the IUGR fetuses indicated poorer placental function, while reduced VO2 may reflect metabolic adaptation to reduced DO2, resulting in slowing of fetal growth. Abnormal CPR and MCA PI are better indicators of late-onset IUGR than UA PI as previously shown3. SVC flow and UV T2 by MRI may be useful markers of IUGR. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article. Supporting information can be found in the online version of this abstract