Foetal cerebral redistribution or 'brain-sparing' is a diagnosis in foetal medicine. It is characterised by preferential flow of blood towards the brain at the expense of the other vital organs, and it occurs as a haemodynamic adaptation in foetuses which have placental insufficiency. The underlying mechanism is thought to be vasodilation of the cerebral arteries. Cerebral redistribution is defined by the presence of a low middle cerebral artery pulsatility index (MCA-PI). Ultrasound of the middle cerebral artery to examine the Doppler waveform is used to establish this. Although cerebral redistribution represents an effort to preserve brain development in the face of hypoxic stress, it is nonetheless associated with adverse neurodevelopmental outcome. The presence of cerebral redistribution will be one factor taken into consideration when deciding whether to artificially deliver a baby with placental insufficiency via induction of labour or caesarian section.
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References
- ^ Eixarch E, Meler E, Iraola A, et-al. Neurodevelopmental outcome in 2-year-old infants who were small-for-gestational-age-term fetuses with cerebral blood flow redistribution. Ultrasound Obstet Gynecol. 2008; 32(7): 894-9. PMID 19035538
- Skandhan, Avni; Knipe, Henry. "Fetal head sparing theory". Radiopaedia.
- Hershkovitz R, Kingdom JC, Geary M, Rodeck CH. Fetal cerebral blood flow redistribution in late gestation: identification of compromise in small fetuses with normal umbilical artery Doppler. Ultrasound Obstet Gynecol. 2000; 15(3): 209-12. PMID 10846776
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