The relationship of foetal superior mesenteric artery blood flow and the time to first meconium passage in newborns with late-onset foetal growth restriction

J Obstet Gynaecol. 2022 Aug;42(6):1978-1983. doi: 10.1080/01443615.2022.2056830. Epub 2022 Jun 1.

Abstract

This study aimed to assess the relationship between the foetal superior mesenteric artery (SMA) Doppler and the time to first meconium passage (FMP) in foetuses with late-onset foetal growth restriction. This single-centre, prospective, observational, cohort study included 57 patients with late-onset FGR. The newborn infants were divided into two groups: preterm (36.8%) and term (63.2%). The time to FMP of the infants was compared to the foetal SMA parameters obtained within a week before delivery. The median time to FMP was similar between two groups (p = .31). The SMA pulsatility index (PI) was higher in the preterm group (p < .01). There was no correlation between foetal SMA PI or resistance index and time to FMP. In late-onset FGR infants, our study found no association between SMA Doppler measurements and time to FMP. However, a significant difference was detected in SMA PI between preterm and term infants. Impact StatementWhat is already known in this subject? Foetal growth restriction (FGR) can affect splanchnic circulation of the foetus and this alteration can be associated with some disorders including necrotising enterocolitis.What do the results of this study add? Superior mesenteric artery (SMA) Doppler indices are not associated with first meconium passage in neonates with late-onset foetal growth restriction. The pulsatility index of SMA is significantly higher in foetuses delivered before term.What are the implications of these findings for clinical practice and/or further research? Further research should be conducted to investigate the relationship between foetal SMA Doppler indices and neonatal gastrointestinal morbidities in foetuses with early onset FGR with Doppler anomalies. These studies can shed light from the prenatal to the postnatal period, allowing clinicians to predict potential problems and take precautions.

Keywords: Foetal growth restriction; first meconium passage; late-onset; superior mesenteric artery doppler; umbilical artery doppler.

Publication types

  • Observational Study

MeSH terms

  • Cohort Studies
  • Female
  • Fetal Growth Retardation* / diagnostic imaging
  • Humans
  • Infant, Newborn
  • Meconium
  • Mesenteric Artery, Superior* / diagnostic imaging
  • Mesenteric Artery, Superior* / physiology
  • Pregnancy
  • Prospective Studies
  • Ultrasonography, Doppler / methods
  • Ultrasonography, Prenatal / methods