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Cerebral blood flow autoregulation and congenital heart disease: possible causes of abnormal prenatal neurologic development
- Source :
- The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. 24(10)
- Publication Year :
- 2011
-
Abstract
- To determine whether the major congenital heart diseases (CHDs) can modify the cerebrovascular flow dynamics and the biometrical parameters in fetuses at third trimester of pregnancy.We studied 60 fetuses with CHD. Data included prenatal versus postnatal cardiac diagnosis, cerebral and umbilical artery doppler, fetal biometrical parameters, fetal weight, and gestational age. The pulsatility index (PI) was used to determine blood flow velocities in the umbilical artery (UA) and middle cerebral artery (MCA), while the cerebro/placental ratio (CPR) was assessed as a measure of cerebral autoregulation. Fetuses with CHD were compared to normal controls and then analyzed after being divided into groups based on specific defects.Compared with control fetuses, those with CHD showed a decrease of resistance blood flow in the middle cerebral artery (1.76 vs 1.92 PI) especially considering the CPR (1.66 vs 2.03 PI) (p0.01). Furthermore, fetuses with CHD also had smaller head circumferences (30.6 cm vs 31.5 cm p0.01) and head/abdominal (HC/AC) ratio (1 vs 1.05 p0.01). When stratified for single cardiac diseases, fetuses with hypoplasic left heart syndrome showed a lower CPR and HC/AC ratio.Cerebrovascular resistance is significantly lower in fetuses with CHD, especially in cases of left side obstruction. The cerebro/placental hemodynamic changes are similar to that described in fetuses with placental insufficiency and may contribute to their abnormal neurologic development.
- Subjects :
- Heart Defects, Congenital
medicine.medical_specialty
Biometry
Heart disease
Hemodynamics
Cerebral autoregulation
Nervous System
Ultrasonography, Prenatal
Fetal Development
Pregnancy
medicine.artery
Internal medicine
medicine
Homeostasis
Humans
cardiovascular diseases
Congenital heart disease
Echocardiography, Doppler, Pulsed
Fetus
Fetal echocardiography
medicine.diagnostic_test
business.industry
Obstetrics and Gynecology
Umbilical artery
Cerebrovascular circulation
medicine.disease
Echocardiography, Doppler, Color
Settore MED/40 - GINECOLOGIA E OSTETRICIA
Cerebral blood flow
Cerebrovascular Circulation
Pediatrics, Perinatology and Child Health
Middle cerebral artery
Cardiology
Female
business
Subjects
Details
- ISSN :
- 14764954
- Volume :
- 24
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- The journal of maternal-fetalneonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
- Accession number :
- edsair.doi.dedup.....dd815ebdf26163ad926705881cc7a3b8