Association between maternal oxygenation and brain growth in fetuses with left‐sided cardiac obstructive lesions
ABSTRACT Objective Impaired brain growth has been observed in fetuses with left‐sided obstructive lesions (LSOL). Maternal oxygenation (MO) can alter fetal cerebral oxygenation and vascular reactivity. Our aim was to observe whether brain growth improves during MO in fetuses with LSOL. Methods Forty...
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Published in | Ultrasound in obstetrics & gynecology Vol. 60; no. 4; pp. 499 - 505 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Chichester, UK
John Wiley & Sons, Ltd
01.10.2022
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | ABSTRACT
Objective
Impaired brain growth has been observed in fetuses with left‐sided obstructive lesions (LSOL). Maternal oxygenation (MO) can alter fetal cerebral oxygenation and vascular reactivity. Our aim was to observe whether brain growth improves during MO in fetuses with LSOL.
Methods
Forty‐six fetuses with LSOL and 23 control fetuses were enrolled in this prospective longitudinal study. Fetuses with LSOL were subgrouped into those with MO (LSOL‐MO, n = 23) and those without MO (LSOL‐nMO, n = 23). Fetal head circumference (HC) and total intracranial volume (TIV) were evaluated serially at 4‐week intervals. Brain biometry and growth were analyzed using linear mixed models adjusted for gestational age and sex. Spearman's correlation coefficients were calculated to identify baseline characteristics predictive of brain growth in the LSOL‐MO group.
Results
Duration of MO therapy had significant interaction effects on cerebral biometry in fetuses with LSOL. TIV increased more rapidly after 8 weeks of oxygen exposure and HC was larger after 16 weeks of oxygen exposure in the LSOL‐MO group compared with the LSOL‐nMO group (P < 0.001). The change in TIV at the final time‐ point relative to the initial timepoint in the LSOL‐MO group correlated negatively with the baseline pulsatility index of the middle cerebral artery (r = –0.58, P = 0.003) and baseline myocardial performance index of the left ventricle (r = –0.68, P < 0.001).
Conclusions
TIV and HC increased faster in fetuses with LSOL which had MO compared with those that did not. Lower cerebral vascular resistance and preserved left heart function at baseline may predict greater cerebral biometric growth during MO. Additional research, including larger serial studies, is needed to confirm these preliminary findings and evaluate the clinical application of MO in this population. © 2022 International Society of Ultrasound in Obstetrics and Gynecology. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0960-7692 1469-0705 |
DOI: | 10.1002/uog.24927 |