Barrios-Prieto E, González-Gallo SL

Language: Spanish
References: 14
Page: 262-268
PDF size: 731.46 Kb.

ABSTRACT

The primary aim of fetal surveillance is to identify fetuses at risk of hypoxia-asphyxia, in order to make the proper management and reduce the risk of stillbirth and sequels neurological. The advances in understanding the pathophysiology of growth restriction (IUGR) and hypoxia-asphyxia and technological advances in ultrasound applications Doppler, have identified these entities as part of a spectrum of placental disease at Placental Insufficiency.
The proper development of the uteroplacental circulation is essential in achieving a pregnancy normal, a suboptimal maternal adaptation with nutrient transport deficient resulting limited placental function even in its formation. The spectrum of manifestations in the fetus is determined by compensatory responses in various organs and systems, but if the mechanisms compensatory are not efficient, are damaged I could progress to fetal death.
Placental insufficiency fetal compromise is expressed in varying degrees, in the preclinical phase of disease findings found as the presence of increased pulsatility index (IP) of the uterine arteries with the presence of a bilateral early diastolic notch at weeks 11 -14 of gestation. Clinical phase umbilical artery and the middle cerebral artery are first parameters affected, with a progressive deterioration from early stages, but late changes Umbilical artery not adequately reflect the clinical condition or severity of disease, therefore not by themselves predict morbidity and fetal mortality. The DV is the parameter that has shown greater association with perinatal morbidity and mortality, by this reason the absence or reversal of wave “a” persistently, is of major determinants for termination of pregnancy at early ages.

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