Assessment of fetal distress based on magnetic resonance examinations: preliminary report

Acad Radiol. 2003 Nov;10(11):1274-82. doi: 10.1016/s1076-6332(03)00331-3.

Abstract

Rationale and objectives: Hypoxia is the main cause of injuries and intrauterine death of the fetus. Therefore, the main aim of monitoring and assessment of the fetus should be diagnosis of fetal distress before irreversible changes occur. Besides the fetal condition assessment methods used so far, in recent years in obstetrics new non-invasive imaging methods were introduced such as magnetic resonance (MR). This method enables morphologic evaluation of brain and brain tissue metabolism using magnetic resonance spectroscopy (MRS).

Materials and methods: Twenty pregnant women with pregnancy-induced hypertension (11 cases, including 3 with coexisting diabetes mellitus and 2 with intrauterine growth retardation), chronic hypertension (2 cases), gestational diabetes mellitus (6 cases), and suspected intrauterine fetal growth retardation (IUGR) participated in the study. Cardiotocography (CTG) and Doppler ultrasound examination of the blood flow in the umbilical artery and in the middle cerebral artery were performed.

Results: In case of abnormal CTG and Doppler study records that indicated fetal hypoxia, MR studies showed the existence of ischemic focus in 5 patients and abnormal spectral images in 6 patients.

Conclusion: The results of the preliminary study suggests that the use of MR in prenatal diagnosis may revolutionize the early detection of fetal injury in fetal distress. It is a valuable component of the diagnostic process, supplementing other examinations. The use of MR to assess fetal condition gives additional information and helps to make decisions about therapeutic actions.

MeSH terms

  • Adult
  • Brain / anatomy & histology
  • Cardiotocography
  • Female
  • Fetal Distress / diagnosis*
  • Fetal Growth Retardation / complications
  • Fetal Hypoxia / diagnosis
  • Fetus
  • Humans
  • Hypertension / complications
  • Magnetic Resonance Imaging*
  • Magnetic Resonance Spectroscopy*
  • Pregnancy
  • Pregnancy in Diabetics / complications
  • Ultrasonography, Prenatal