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  Česky / Czech version Čes. Gynek., 66, 2001, No. 2, p. 91-96
 
Differentiated Evaluation of Blood Flow Middle Cerebral Artery in Relation to the Foetal Well-being  
Rozpravka P., Ostro A., Pačin J.: 

II. gyn.-pôrod. klinika, FN L. Pasteura, Košice, Slovenská republika
 


Summary:

       Objective: To estate clinical signification of differentiated evaluation dopplervelocimetry middle cerebral artery (MCA) of ultrasonografically detected intrauterine growth retarded (IUGR) foetuses, during pregnancies complicated hypertension (PIH) and preeclampsia. Methods: In prospective comparative clinical study evaluated dopplervelocimetric curve MCA eseparatelly in proximal (basal) segment (PS) and distal (cortical) anatomical segment (DS). Valu- es of pulzatility index (PI) were compared in proximal and distal segment MCA. Corticocerebral index (CCI) was estated as ratio PIPS/PIDS. Results were compared in the group-A with IUGR detected and in control group-B with normal growth of the foetuses. Period of measurements complex biometry was 1 week, foetal flowmetry minimally 24 hours, maximally 1 week. Results: Values of PI in PS and DS MCA were significantly different. Rezistance of MCA in cortical direction decreases. Values of PIPS were higher comparing PIDS. We finded statistically signifi- cant correlation CCI > 1 and chronical foetal hypoxy resulted in IUGR. Differenciated flow analy- sis of MCA did not show statistically significant differencies of PIPS and PIDS. Calculated CCI = 1. MCA rezistance does not showed changes in cortical direction. We finded significantly higher statistical occurance of perinatal complications of the foetuses, ellective Cesarion Sections for foetal intrauterine hypoxy, when values of CCI > 1. This is the fact concluded worse prognosis the foetuses with cortical sparing effect in utero, but also worse postnatal adaptation. Conclusion: Corticocerebral index is simple parameter for detection of different saturation of the brain of the foetus under hypoxemia. Foetal prosperity in utero has coming worse during cortical preservation. There is significantly higher occurance of perinatal complications.

        Key words: intrauterine growth retarded, complicated pregnancy, corticocerebral index
       

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