Fetal Hemodynamics and Brain Development in Late Onset Intrauterine Growth Restriction

Late-onset intrauterine growth restriction (IUGR) results from placental insufficiency. It has an adverse impact on brain development. However, the relationships between placental function, fetal hemodynamics and cerebral maturation in human IUGR are poorly understood. This thesis describes our findings using MRI technology in late-onset IUGR. We measured key hemodynamic parameters and compared them with indices of brain development in neonates following late-onset IUGR. MRI revealed the expected adaptive responses to hypoxia in IUGR fetuses. MRI parameters including flow in the superior vena cava and oxygen delivery could be useful markers of late-onset IUGR. We also observed reduced cerebral oxygen delivery in IUGR fetuses, which could be associated with reduced brain growth and delayed white matter development. Preliminary data indicated that IUGR was impacting subsequent neurodevelopmental outcomes. Our finding would suggest that MRI could provide useful adjunct to current monitoring and help define the optimal timing of delivery of late-onset IUGR.M.Sc