Diferencované hodnotenie prietoku arteriacerebri media vo vzťahu k stavu plodu

Differentiated Evaluation of Blood Flow MiddleCerebral Artery in Relation to the Foetal Well-being

Objective:
To estate clinical signification of differentiated evaluation dopplervelocimetry middlecerebral 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 MCAeseparatelly 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. Corticocerebralindex (CCI) was estated as ratio PIPS/PIDS. Results were compared in the group-A with IUGRdetected and in control group-B with normal growth of the foetuses. Period of measurementscomplex 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 corticaldirection 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 higherstatistical occurance of perinatal complications of the foetuses, ellective Cesarion Sections forfoetal intrauterine hypoxy, when values of CCI > 1. This is the fact concluded worse prognosisthe foetuses with cortical sparing effect in utero, but also worse postnatal adaptation.Conclusion: Corticocerebral index is simple parameter for detection of different saturation of thebrain of the foetus under hypoxemia. Foetal prosperity in utero has coming worse during corticalpreservation. There is significantly higher occurance of perinatal complications.

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