Oximetría esplácnica en neonatos pequeños para la edad gestacional en relación con el estudio doppler prenatal

Abstract

Resumen: Introducción: El estudio del doppler fetal permite identificar la etiología placentaria y clasificar su gravedad en aquellos neonatos pequeños para la edad gestacional. Existen estudios que relacionan estos datos doppler con alteraciones en el flujo intestinal del recién nacido, pero su relación con los datos de oximetría intestinal ha sido poco estudiada. Objetivo: Evaluar si existe relación entre los datos doppler prenatales y los datos de oximetría abdominal en los niños pequeños para su edad gestacional. Material y métodos: Estudio prospectivo observacional en neonatos > 32 semanas con un peso al nacer 32 weeks with a birth weight < P10. The severity of placental insufficiency was classified according to prenatal Doppler criteria. Splanchnic oximetry was monitored during the first three days of life and a comparative analysis of the oximetry data was performed according to the prenatal Doppler alteration severity. Results: A total of 53 patients were evaluated. Significant differences were observed in the mean regional oximetry (rSO2) between patients with moderate or severe placental failure and those with normal or slightly altered prenatal Doppler: 42 ± 10 vs. 71.3 ± 10 (P < .001). These differences were maintained during the first 3 days of life. Standard patterns of splanchnic oximetry were identified depending on the degree of placental insufficiency. Conclusions: There is a correlation between the foetal Doppler and the splanchnic oximetry pattern during the first days of life. Neonates with moderate or severe placental insufficiency have more altered abdominal oximetry patterns, making it a useful technique to evaluate the degree of placental insufficiency and the risk of oral intolerance in small for gestational age neonates.

Keywords

• Splanchnic oximetry
• Small for gestational age
• Intrauterine growth restriction
• Prenatal Doppler
• Placental insufficiency