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Updated: Mar 24, 2026
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Relationship between general movements in neonates who were growth restricted in utero and prenatal Doppler flow
J C Tanis1,2, D M Schmitz1, M R Boelen1
1Department of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Insights
Fetal Doppler measurements in growth restriction correlate with neonatal movements at one week but not three months. Abnormal brain sparing in fetuses is linked to poorer quality general movements in newborns.
Area of Science:
- Perinatal medicine
- Fetal development
- Neonatal neurology
Background:
- Fetal growth restriction (FGR) poses risks to neonatal neurodevelopment.
- Doppler pulsatility indices (PIs) assess fetal circulation and can indicate placental insufficiency.
- General movements (GMs) are a sensitive indicator of fetal and neonatal neurological function.
Purpose of the Study:
- To determine if fetal Doppler PIs in FGR pregnancies correlate with the quality of neonatal GMs.
- To investigate the association between specific Doppler parameters (umbilical artery, middle cerebral artery, ductus venosus) and neonatal motor optimality score (MOS).
Main Methods:
- Prospective observational cohort study of 48 FGR pregnancies.
- Fetal Doppler PIs (umbilical artery, middle cerebral artery, ductus venosus) measured within one week of delivery.
- Cerebroplacental ratio (CPR) calculated as MCA-PI/UA-PI.
- Neonatal GMs assessed at 7 days, around due date, and 3 months post-term using MOS.
Main Results:
- Fetal Doppler PIs of the umbilical artery (UA-PI), middle cerebral artery (MCA-PI), and CPR showed strong correlations with MOS at 7 days postpartum (ρ, -0.374 to 0.472; P < 0.01).
- Ductus venosus PI (DV-PI) did not correlate with MOS at 7 days.
- No significant correlations were found between Doppler PIs and MOS at 3 months post-term.
Conclusions:
- Fetal arterial Doppler measurements, particularly those reflecting brain sparing (e.g., CPR), are associated with the quality of neonatal general movements one week after birth.
- This association diminishes by 3 months postpartum, suggesting early neurological adaptation or recovery.
- Abnormal fetal Doppler findings in FGR may predict suboptimal neonatal motor quality in the short term.
Objective:
To investigate whether Doppler pulsatility indices (PIs) of the fetal circulation in cases of fetal growth restriction (FGR) are associated with the general movements (GMs) of the neonate after birth.
Methods:
This was a prospective observational cohort study including pregnancies with FGR diagnosed between June 2012 and September 2014. A diagnosis of FGR was based on an abdominal circumference or estimated fetal weight < 10th percentile (in conjuction with abnormal Doppler) or declining fetal growth of at least 30 percentiles with respect to previous size measurements. Doppler parameters of the umbilical artery (UA), fetal middle cerebral artery (MCA) and ductus venosus (DV) were measured maximally 1 week prior to delivery. Cerebroplacental ratio (CPR) was calculated as MCA-PI divided by UA-PI. We assessed the quality of neonatal GMs 7 days after birth, around the due date if cases were born preterm, and at 3 months post-term. We performed a detailed analysis of the motor repertoire by calculating a motor optimality score (MOS).
Results:
Forty-eight FGR cases were included with a median gestational age at delivery of 35 (range, 26-40) weeks. UA-PI, MCA-PI and CPR correlated strongly (ρ, -0.374 to 0.472; P < 0.01) with the MOS on day 7 after birth, but DV-PI did not. Doppler PI measurements did not correlate with MOS at 3 months post-term.
Conclusion:
Fetal arterial Doppler measurements are associated with the quality of neonatal GMs 1 week after birth, but this association is no longer evident at 3 months post-term. Brain sparing in particular is associated strongly with GMs of an abnormal quality. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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