Is the fetal brain-sparing effect a risk factor for the development of intraventricular hemorrhage in the preterm infant?

Giancarlo Mari, A. Z. Abuhamad, M. Kelle, B. Verpairojkit, L. Ment, J. A. Copel

Research output: Contribution to journalArticle

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Abstract

The intrauterine identification of fetuses at risk of developing intraventricular hemorrhage would be helpful to the perinatologist, in light of the recent results which suggest that indomethacin given to the infant reduces the risk of developing intraventricular hemorrhage. We hypothesized that fetuses undergoing brain sparing, as identified by a lowered pulsatility index (PI) in the middle cerebral artery, and delivered prior to 34 weeks may differ in terms of being at risk for intraventricular hemorrhage from those fetuses without the brain-sparing effect. The middle cerebral artery PI was studied in 43 fetuses between 25 and 33.6 weeks' gestation. The pregnancies were complicated by pre-eclampsia, intrauterine growth restriction (IUGR) and preterm labor. A cranial sonogram was performed during the first postnatal week in all the neonates. Intraventricular hemorrhage was present in 6/22 infants with a normal middle cerebral artery PI (group A) and 0/21 with an abnormal middle cerebral artery PI (group B) (p < 0.05). The mothers of the six fetuses who developed intraventricular hemorrhage undenuent preterm labor. IUGR fetuses and pre-eclampsia were more common in group B. No difference was found between the two groups when the following variables were compared: (1) gestational age at the time of the Doppler study; (2) gestational age at delivery; (3) antenatal exposure to steroids; (4) antenatal exposure to magnesium; (5) Apgar score greater than 6 at 5 min; (6) respiratory distress syndrome in the newborn; (7) necrotizing enterocolitis; (8) Cesarean section; and (9) sepsis in the infant. Although the mean birth weight was significantly lower in group B than group A, no fetus in this group developed intraventricular hemorrhage. The fetal brain-sparing effect, pre-eclampsia and IUGR were associated with a lower risk of neonatal intraventricular hemorrhage than was preterm labor. Preterm labor appears to be a key factor in the development of intraventricular hemorrhage and must be included when testing associations with intraventricular hemorrhage.

Original languageEnglish (US)
Pages (from-to)329-332
Number of pages4
JournalUltrasound in Obstetrics and Gynecology
Volume8
Issue number5
DOIs
StatePublished - Jan 1 1996
Externally publishedYes

Fingerprint

Premature Infants
Hemorrhage
Fetus
Brain
Premature Obstetric Labor
Middle Cerebral Artery
Pre-Eclampsia
Gestational Age
Growth
Newborn Respiratory Distress Syndrome
Pregnancy
Necrotizing Enterocolitis
Apgar Score
Birth Weight
Indomethacin
Cesarean Section
Magnesium
Sepsis
Steroids
Mothers

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynecology

Cite this

Is the fetal brain-sparing effect a risk factor for the development of intraventricular hemorrhage in the preterm infant? / Mari, Giancarlo; Abuhamad, A. Z.; Kelle, M.; Verpairojkit, B.; Ment, L.; Copel, J. A.

In: Ultrasound in Obstetrics and Gynecology, Vol. 8, No. 5, 01.01.1996, p. 329-332.

Research output: Contribution to journalArticle

Mari, Giancarlo ; Abuhamad, A. Z. ; Kelle, M. ; Verpairojkit, B. ; Ment, L. ; Copel, J. A. / Is the fetal brain-sparing effect a risk factor for the development of intraventricular hemorrhage in the preterm infant?. In: Ultrasound in Obstetrics and Gynecology. 1996 ; Vol. 8, No. 5. pp. 329-332.
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