Prematüre bebeklerde prenatal Doppler Ultrasonografi bulguları ile postnatal serebral Near-Infrared Spektroskopi (NIRS) ölçümlerinin uyumluluğunun araştırılması

Abstract

Perinatal and neonatal surveillance of intrauterine growth restriction (IUGR) has gained importance due to its negative impacts on cerebral oxygenation. In this thesis study, it was aimed to compare fetal cerebral and umbilical Doppler Ultrasonography (US) measurements with cerebral Near-Infrared Spectroscopy (NIRS) measurements at first 24 hours of neonatal period in babies born before the 35th gestational week of pregnancy. Among the cases meeting the study criteria (n=37), those with IUGR formed the study group (n=24) whereas those who have not constituted the control group (n=13). Prenatal Doppler US measurements revealed that in the study group, middle cerebral artery measurements had higher mean end diastolic velocity (p=0.024) and lower mean pulsatility index (p=0.028) whereas umbilical artery measurements had lower mean end diastolic velocity (p=0.015) and higher mean pulsatility index (p=0.015). When examined in terms of NIRS measurements; there was no statistically significant difference between the groups in terms of mean composite measurements at baseline, 15th, 30th minutes, 1st, 3rd, 6th, 12th and 24th hours. When the effects of group and time on NIRS measurements were examined separately, there was no statistical significance at the 95% confidence level (p=0.235 and p=0.723, respectively). According to the prenatal Doppler USG findings, subgroups that were thought to have different levels of IUGR clinical severity were formed. There was no statistically significant difference between the groups in terms of neonatal NIRS measurements, prematurity morbidities and neonatal mortality. It was considered that negative changes in prenatal Doppler US findings did not reveal clinical findings in fetus and newborn up to a certain point, and that other variables were thought to play a role affecting the results in infants with IUGR. As a result of the combined effect of good perinatal and neonatal care, it was concluded that there may be no difference between the groups in terms of clinical findings and measured values. The combination and integration of widely used fetal Doppler USG with neonatal cerebral NIRS methods will increase the data on neonatal outcomes of fetal IUGR and will be beneficial.