Document Detail

Neonatal cerebral arterial flow velocity waveforms in term infants with and without metabolic acidosis at delivery.
MedLine Citation:
PMID:  7493584     Owner:  NLM     Status:  MEDLINE    
To define the effects of acid base status at delivery on neonatal cerebral artery flow velocity waveform patterns obtained using Doppler ultrasound during the first week of life, a longitudinal comparative study of neonates born at term with and without evidence of metabolic acidosis in the umbilical artery was undertaken. Eighty-two appropriate for gestational age infants delivered after uncomplicated pregnancies with non-acidotic umbilical artery blood gases and in whom no neonatal complications were noted were studied to establish reference values of neonatal cerebral arterial vascular resistance index (RI) in normal term infants during the first week of life. A further 189 infants were grouped according to the presence and severity of metabolic acidosis at delivery, and also the presence of high risk features in the antenatal period. In the normal non-acidotic infants, over the first 24 h of life, there was a significant fall in the cerebral arterial resistance index (RI) in all the vessels examined, after which a steady state value was attained with no significant changes in vascular resistance index being noted during the remainder of the study period. The fall in RI between 12 and 24 h of age was consistent in all study groups. Infants with metabolic acidosis at delivery had blood flow patterns compatible with decreased resistance to flow in both anterior and middle cerebral arteries which persisted throughout the first week of life. This reduction in cerebral vascular resistance was most marked in those infants with severe metabolic acidosis. The majority of severely acidotic infants had a benign clinical outcome in the first week of life and all infants had normal cerebral ultrasound scans during the neonatal period. These findings suggest that metabolic acidosis at birth is associated with changes in neonatal cerebral arterial vascular resistance during the first week of life, and in the presence of benign clinical course the significance of this observation with regard to neurodevelopmental outcome requires evaluation.
F K Morrison; N B Patel; P W Howie; G J Mires; R M Herd
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Early human development     Volume:  42     ISSN:  0378-3782     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  1995 Aug 
Date Detail:
Created Date:  1996-01-11     Completed Date:  1996-01-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  155-68     Citation Subset:  IM    
Department of Obstetrics and Gynaecology, Ninewells Hospital and Medical School, Dundee, UK.
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MeSH Terms
Acidosis / physiopathology*,  ultrasonography
Blood Flow Velocity
Cerebral Arteries / physiopathology*,  ultrasonography
Gestational Age
Infant, Newborn
Longitudinal Studies
Vascular Resistance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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