The predictive value of lactate peak detected by the magnetic resonance spectroscopy in the brain of growth-restricted fetuses for adverse perinatal outcomes. (1st October 2016)

• Record Type: Journal Article
• Authors: Doğer, Emek; Özdamar, Özkan; Çakıroğlu, Yiğit; Ceylan, Yasin; Çakır, Özgür; Anık, Yonca; Çalışkan, Eray
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 19(2016)
• Page Start: 3178
• Page End: 3182
• Publication Date: 2016-10-01
• Subjects: Fetal growth restriction -- lactate -- magnetic resonance spectroscopy -- perinatal death; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2015.1118040
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To compare perinatal outcomes between patients with and without abnormal Doppler findings and lactate peak in the fetal brain detected by magnetic resonance spectroscopy ( 1 HMRS) and to assess the feasibility of fetal brain lactate in the prediction of adverse obstetric outcomes in growth-restricted fetuses. Methods : Pregnancies with FGR fetuses underwent Doppler ultrasonography and 3 Tesla 1 HMRS for the presence of lactate peak prior to the delivery. Patients were assigned into the following groups; normal Doppler, no lactate peak (Group 1), normal Doppler, lactate peak (+) (Group II), abnormal Doppler, no lactate peak (Group III), abnormal Doppler, lactate peak (+) (Group IV). Results : Five perinatal deaths, all in Group IV, were encountered ( p < 0.001). Perinatal death rate was higher in patients with Doppler flow abnormality ((5/12 (41.7%)) than in patients without Doppler abnormality (0/23) ( p < 0.001) and was significantly higher in the presence (5/18 (27.8%)) than in the absence of lactate peak (0/17) ( p = 0.019). Conclusions : Fetuses with brain lactate peak detected by 1 HMRS in addition to altered Doppler findings are more likely to develop short-term morbidities and perinatal death. Fetal brain lactate detected by 1 HMRS may represent a clinical marker of altered brain metabolism and further perinatal complications.