Postnatal neuro-development of fetuses with absent end-diastolic flow in the umbilical artery and/or fetal descending aorta |
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Authors: | Ertan A Kubilay Tanriverdi H Alper Stamm Alexander Jost Wolfgang Endrikat Jan Schmidt Werner |
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Affiliation: | 1. Department of Obstetrics and Gynecology, Hospital of Leverkusen, Teaching Hospital of University of Cologne, 51375, Leverkusen, Germany 2. Department of Obstetrics and Gynecology, Adnan Menderes University Medical School, Aydin, Turkey 3. Department of Obstetrics and Gynecology, Saarland University Medical School, Homburg, Saarland, Germany 4. Department of Neuropediatrics, Saarland University Medical School, Homburg, Saarland, Germany
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Abstract: |
Objective To determine whether absence of end-diastolic flow in the umbilical artery and/or fetal aorta impacts postnatal neuro-development in preterm-born children. Methods The study group, consisting of 43 fetuses with absent end-diastolic flow in the umbilical artery and/or fetal aorta, was compared with a control group, consisting of 30 fetuses, matching for gestational age but with normal doppler-flow results. The children’s neuro-developmental status was assessed using the ‘Munich functional developmental diagnostics’ (MFDD), between the 2nd and 3rd year of life. Results Gestational age at birth was 33?+?6?weeks in the study group and 34?+?4?weeks in the control group. A brain-sparing effect was observed in 37.3% of fetuses in the study group compared with 10.0% in the control group (p?=?0.014). For all seven MFDD domains, the number of children with deficiencies was higher in the study group. For the domains perception, active speech and comprehension this effect was statistically significant (p?0.05). Overall, 30.2% of children in the study group and 16.7% of the control group had pathologic test results (p?0.013). Conclusion Pathological doppler-flow in the umbilical artery and/or fetal descending aorta in preterm born children is associated with neuro-developmental deficiencies. Intensive pediatric care is recommended to mitigate these deficiencies during early childhood. |
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