FETAL HYPOXIA AND UTERINE BLOOD FLOW IN PATIENTS WITH FETAL GROWTH RETARDATION
Keywords:Fetal growth restriction, blood gases, hypoxia, ultrasound doppler
Purpose: to assess fetal hypoxia and blood flow in the umbilical and middle cerebral arteries in fetal growth retardation (FGR). 97 pregnant women were examined, of which 77 had pregnancy complicated by FGR (main group), 20 women had pregnancy without complications (control group). The gestation period is 37-38 weeks. Measured blood gases (CO2 and pCO2), pH in the umbilical artery and vein. The systolic/diastolic ratio (S/D) was determined in the umbilical artery and middle cerebral artery (MCA); pulsation index (PI), resistance index (RI) and cerebroplacental ratio (CPR). FGR type 1 was diagnosed in 57.1% of cases, FGR type 2 in 42.9% of cases. The pH value in the umbilical artery and venous blood in the main group was on average significantly lower than in the control group (p<0.001, respectively). The average pO2 level was reduced in the main group in the umbilical artery (p=0.009) and in the venous blood (p=0.002). The average value of pCO2 in cord blood of the main group was significantly increased in arterial blood (p=0.035) and venous blood (p<0.001). The average values of S/D, PI and RI of the umbilical artery were significantly higher in the main group compared to the control (p<0.05). In MCA, the S/D indicator was lower (p=0.045). The CPR value in the main group was 28.7% lower than in the control group (p=0.086). In the main group, CPR correlated with all blood gases with an average, statistically significant relationship, and an average inverse relationship was noted with pCO2 (r=-0.577, p=0.054). Doppler indices (PI, RI) of the umbilical and middle cerebral arteries, as well as the cerebro-placental ratio, should be measured during prenatal monitoring of pregnancies with IGR, and should be an integral part of the assessment of a fetus with growth retardation.
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