Friday, July 28, 2023

Tiny But Mighty: The Journey of an Early IUGR Warrior at 27 Weeks

Ultrasound imaging findings:
In our case, the BPD corresponds to 28 weeks, but the AC corresponds to 25 weeks. This suggests that the fetus is measuring smaller than expected for its gestational age. This is known as intrauterine growth restriction (IUGR), and it can be caused by a number of factors, including placental insufficiency, maternal hypertension, and diabetes.

The estimated fetal weight of 910 grams is also lower than expected for a 27-week fetus. This further suggests that the fetus is experiencing IUGR.

Color Doppler imaging:
The cerebroplacental ratio (CPR) is a measure of the blood flow resistance in the middle cerebral artery (MCA) compared to the umbilical artery (UA). A normal CPR is between 1.0 and 1.5. A CPR of            0.63/0.75 <1and  is slightly reversed, meaning that the blood flow resistance in the MCA is lower than the blood flow resistance in the UA. This is typically seen in cases of placental insufficiency, where the placenta is not able to deliver enough oxygen and nutrients to the fetus.

The increased RI values in the uterine artery and umbilical artery also suggest that the placenta is not functioning properly. The increased RI values in these arteries are a sign of increased resistance to blood flow, which can be caused by a number of factors, including placental insufficiency, maternal hypertension, and diabetes.

In our case, the combination of a reversed CPR and increased RI values in the uterine artery and umbilical artery suggests that the placenta is not functioning properly. This can put the fetus at risk for growth restriction, preterm birth, and other complications.


Here are some additional information about the cerebroplacental ratio:

* The CPR is calculated by dividing the pulsatility index (PI) of the MCA by the PI of the UA.
* A normal CPR is between 1.0 and 1.5.
* A reversed CPR is a sign of placental insufficiency.
* A reversed CPR can put the fetus at risk for growth restriction, preterm birth, and other complications.

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