WS08‐06Fetal hemodynamics, hypoxia index and brain damage

Objective To estimate the value of a new vascular score, hypoxia index (HI), in prediction of functional and/or structural brain lesions caused by fetal hypoxia and to examine the relationship between this index, Doppler cerebral-umbilical ratio (C/U) and neonatal neurosonography in growth retarded and hypoxia fetuses. Study design In the prospective study 41 growth retarded fetuses were included from 29 to 40 weeks of gestation. Flow velocity waveforms the umbilical and middle cerebral arteries were recorded each other day, at least two weeks. The C/U ratio and HI were calculated. After the birth, obstetric parameters and ultrasound of neonatal brain were used as outcome parameters. Results Doppler C/U ratio  150 were associated with poor perinatal outcome. The neonatal brain damage was detected in 16 growth-retarded and hypoxic fetuses. Hypoxia index had greater statistic significance in the prediction of neonatal brain lesions. Also, specificity and sensitivity of HI was better than the last value of C/U ratio measured before delivery. Conclusions The C/U ratio and HI represent the best indicators for early detecting and assessment of fetal hypoxia. Furthermore, they may also be parameters for the prediction of poor neurological outcome in pregnancies with growth retardation. So, the use of HI would represent a significant advance in prevention of hypoxic brain lesions, which are one of the most frequent causes of perinatal morbidity and mortality.