New Doppler index for prediction of perinatal brain damage in growth-restricted and hypoxic fetuses
New Doppler index for prediction of perinatal brain damage in growth-restricted and hypoxic fetuses
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DOI：
10.1002/uog.4094
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发表时间：
2007-09-01
影响因子：
7.1
通讯作者：
Salihagic-Kadic, A.
中科院分区：
文献类型：
--
作者：
Jugovic, D.;Tumbri, J.;Salihagic-Kadic, A.
目的探讨新的血管评分法-缺氧指数（hypoxia index，HI）对生长受限胎儿分娩后第1周内超声检测新生儿脑结构病变的预测价值。在分娩前至少2周，每隔48小时记录多普勒脐动脉（UA）和大脑中动脉（MCA）阻力指数（RI）。计算脐带血比（C/U比= MCA-RI/UA-RI）和HI（观察期内C/U比每日降低的总和，即低于临界值1的百分比）。分娩后，根据产科参数和脑部超声检查评估新生儿结局。多普勒指数，C/U比和HI，以及新生儿的临床和生化参数，进行了测试，作为潜在的预测脑病变使用C4.5数据挖掘algorithm.Results新生儿脑病变检测在13个生长受限的胎儿。在C4.5数据挖掘算法测试的所有参数中，仅HI被确定为新生儿脑病变的预测因子。HI也表现出更好的相关性与新生儿的生化参数，如脐静脉氧分压和脐静脉pH值，相比C/U ratio.Conclusions HI，其中考虑到累积缺氧，可以显着提高预测一个不良的神经功能的结果在妊娠并发生长受限和缺氧。Copyright（c）2007 ISUOG.由John Wiley & Sons有限公司出版
Objective To evaluate the new vascular score, hypoxia index (HI), in the prediction of sonograpbically detected structural brain lesions in neonates within the first week after delivery of growth-restricted fetuses.Methods This prospective study included 29 growth-restricted fetuses delivered between 31 and 40 gestational weeks. Doppler umbilical artery (UA) and middle cerebral artery (MCA) resistance indices (RI) were recorded at 48-h intervals for at least 2 weeks before delivery. The cerebroumbilical ratio (C/U ratio = MCA-RI/UA-RI) and the HI (the sum of the daily reductions in C/U ratio, i.e. percentage below the cut-off value of 1, over the period of observation) were calculated. After delivery, neonatal outcome was evaluated according to obstetric parameters and ultrasound examinations of the brain. Doppler indices, C/U ratio and HI, as well as neonatal clinical and biochemical parameters, were tested as potential predictors of brain lesions using the C4.5 data-mining algorithm.Results Neonatal brain lesions were detected in 13 growth-restricted fetuses. Of all the parameters tested by the C4.5 data-mining algorithm, only HI was identified as a predictor of neonatal brain lesions. HI also showed better correlation with neonatal biochemical parameters, such as umbilical venous partial Pressure of oxygen and umbilical venous pH, compared with the C/U ratio.Conclusions HI, which takes into account cumulative oxygen deficit, could significantly improve the prediction of a poor neurological outcome in pregnancies complicated by growth restriction and hypoxia. Copyright (c) 2007 ISUOG. Published by John Wiley & Sons, Ltd.