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Assessment of Pregnancy Outcome in IUGR Fetuses , Using the Doppler Flow Velocimetry of the Umbilical and Middle Cerebral Artery
조성남(SN Cho)
UCI I410-ECN-0102-2009-510-005332300

Objectives:The purpose of this study in intrauterine growth retardation(IUGR) is to assess the relationship between the Doppler flow velocimetry and pregnancy outcome. Study design:356 normal and 159 growth retarded fetuses between 21 and 42 gestati- onal weeks were investigated retrospectively. All IUGR fetuses were divided into four gro- ups according to the results obtained by Doppler flow velocities as follows. 1) Group 1(n= 89):patients had normal umbilical artery resistance index ( Rlu ) and normal middle cerebral artery resistance index ( Rlmca ) 2 ) Group 2 ( n= 9 ):patients had normal Rlu and abnormal Rlmca 3 ) Group 3 ( n=25 ):patients had abnormal Rlu and normal Rlmca 4) Group 4 ( n=36 ): patients had abnormal Rlu and abnormal Rlmca. Results:We obtained normal values of RIu and RImca in oriental. Abnormal cardiotoc- ography(CTG) findings and operative delivery for fetal distress were significantly increased in group 2(p<0.05) and markedly increased in group 3 and 4 ( p<0.01 ) compared with group 1. Adverse neonatal outcome was significantly increased in group 3 and 4 compared with group 1. There is significant increase of adverse neonatal outcome in group 4 compared with group 3 ( p<0.05 ). Conclusions:We obtained the normal values of Rlu , Rlmca and cerebroplacental ratio ( CPR ) in oriental. Adverse neonatal outcome was significantly increased in group 2, 3 and 4 compared with group 1. There is significant increase of adverse neonatal outcome in gr- oup 4 compared with group 3. We also found a strong correlation between the CPR and adverse neonatal outcome in IUGR. In IUGR, centralization of the fetal circulation turned out to exist , resulting in a preferential shunting of blood flow to the fetal brain. Brain-sp- aring effect with Doppler flow velocimetry could be demonstrated by this result.

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