BEHAVIORAL-DEVELOPMENT AND DOPPLER VELOCIMETRY IN RELATION TO PERINATAL OUTCOME IN SMALL FOR DATES FETUSES

Twenty-two small for dates (SFD) fetuses and 96 fetuses from uncomplic ated pregnancies were monitored on two occasions between 27 and 32 wee ks and the second time between 33 and 36 weeks of gestation by studyin g the development of behavioural states (coincidence 1F and 2F; no coi ncidence) and umbilical artery Doppler waveform patterns (UA; Resistan ce Index, RI), Data were related to neurological outcome at 8 months a fter birth. The purpose of this study was to investigate if the develo pment of behavioural state is disturbed in SFD fetuses and if SFD fetu ses who needed to be delivered early and/or had abnormal neurological outcome showed different state development and RI than SFD fetuses del ivered later in pregnancy or with normal neurological outcome, Finally , we studied if there was a relationship between state development and RI. At 27-32 weeks of gestation the percentage of coincidence 2F (C2F %) was lower and the percentage of coincidence 1F (C1F%) and no coinci dence (NOC%) were higher in the SFD fetuses than in the control group. At 33-36 weeks C2F% was lower and NOC% was higher but not statistical ly different (P = 0.2 and P = 0.07, respectively). SFD fetuses who nee ded to be delivered early had poorer state development than SFD fetuse s at lower risk and infants who were abnormal at 8 months of life show ed a higher C1F% and lower C2F% at 27-32 weeks. There were significant correlations between RI on the one hand and NOC% (r = 0.62) and C2F% (r = -0.48) on the other hand at 27-32 weeks in the subgroup with abno rmal neurological outcome. In conclusion, in SFD fetuses there are dis turbances in the development of behavioural states as well in the dist ribution of the periods of coincidence (with a decrease in C2F% and an increase in C1F%). Poorest state development is present in SFD fetuse s at highest risk and in this group there appears to be a significant relationship between the degree of utero-placental insufficiency (RI) and disturbances in behavioural development.