[Splanchnic oximetry in small for gestational age neonates in relation to prenatal doppler study]

An Pediatr (Engl Ed). 2020 May;92(5):253-261. doi: 10.1016/j.anpedi.2019.06.009. Epub 2019 Jul 23.
[Article in Spanish]

Abstract

Introduction: Among small for gestational age neonates, foetal Doppler enables the identification of placental insufficency aetiology and the classification of severity in small for gestational age neonates. There are studies that associate the Doppler data with alterations in the intestinal flow of the newborn, but its relationship with intestinal oximetry has been little studied.

Objective: To assess whether there is a relationship between prenatal Doppler data and abdominal oximetry in small for gestational age neonates MATERIAL AND METHODS: A prospective observational study carried out on neonates>32 weeks with a birth weight<P10. The severity of placental insufficiency was classified according to prenatal Doppler criteria. Splanchnic oximetry was monitored during the first three days of life and a comparative analysis of the oximetry data was performed according to the prenatal Doppler alteration severity.

Results: A total of 53 patients were evaluated. Significant differences were observed in the mean regional oximetry (rSO2) between patients with moderate or severe placental failure and those with normal or slightly altered prenatal Doppler: 42±10 vs. 71.3±10 (P<.001). These differences were maintained during the first 3 days of life. Standard patterns of splanchnic oximetry were identified depending on the degree of placental insufficiency.

Conclusions: There is a correlation between the foetal Doppler and the splanchnic oximetry pattern during the first days of life. Neonates with moderate or severe placental insufficiency have more altered abdominal oximetry patterns, making it a useful technique to evaluate the degree of placental insufficiency and the risk of oral intolerance in small for gestational age neonates.

Keywords: Crecimiento intrauterino retardado; Doppler prenatal; Insuficiencia placentaria; Intrauterine growth restriction; Oximetría esplácnica; Pequeño para edad gestacional; Placental insufficiency; Prenatal Doppler; Small for gestational age; Splanchnic oximetry.

Publication types

  • Observational Study

MeSH terms

  • Biomarkers / blood
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age / blood
  • Infant, Small for Gestational Age / physiology*
  • Intestines / blood supply*
  • Linear Models
  • Male
  • Oximetry / methods*
  • Oxygen / blood*
  • Placental Insufficiency / diagnostic imaging*
  • Placental Insufficiency / physiopathology*
  • Pregnancy
  • Prospective Studies
  • Ultrasonography, Prenatal*

Substances

  • Biomarkers
  • Oxygen