EFFECT OF FETAL BRAINSPARING ON THE EARLY NEONATAL CEREBRAL-CIRCULATION

The effect of antenatal brainsparing on subsequent neonatal cerebral b lood flow velocity (CBFV) was studied in very preterm infants. CBFV wa s determined, using a pulsed Doppler technique, both in the fetal and neonatal period. Neonatally, and transcutaneous tension (TcPco(2)) was monitored simultaneously; daily cranial ultrasound examinations were performed. In infants with evidence of brainsparing a higher mean valu e of CBFV and a different pattern of changes of CBFV during the first week of life was demonstrated compared with infants with normal fetal cerebral haemodynamics. No differences were found in blood pressure an d TcPco(2), The incidence of intracranial haemorrhages and of ischaemi c echodense lesions was also the same for both groups. In a multivaria te statistical model gestational age, antepartum brainsparing, and TcP co(2) all contributed significantly in explanation of variation in CBF V. It is speculated that a different setting of cerebral autoregulatio n related to differences in gestational age or to brainsparing might e xplain the difference in changes found in neonatal CBFV.