{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T01:34:46Z","timestamp":1787794486854,"version":"build-2784847793"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T00:00:00Z","timestamp":1259625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess changes in the Doppler flow profiles of the middle cerebral artery in fetuses with cardiac defects theoretically associated with impaired cerebral oxygen delivery <jats:italic>in utero<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Z\u2010scores were calculated for pulsatility and resistance indices (PI and RI, respectively) of the middle cerebral artery (MCA) and the cerebroplacental ratio (CPR) between 19 and 41 weeks' gestation, and for head circumference at birth (HC), in 113 fetuses with the following isolated cardiac defects: transposition of the great arteries (TGA; n = 18), hypoplastic left heart (HLH; n = 46), severe aortic stenosis (n = 17), pulmonary atresia (n = 18) and tetralogy of Fallot (TOF; n = 14). Pregnancies with uteroplacental dysfunction (indicated by increased uterine and\/or umbilical Doppler indices), growth restriction, extracardiac malformations, chromosomal anomalies as well as multiple pregnancies were excluded to avoid any additional hypoxemic effect as strictly as possible. The results were compared with 1378 normal controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fetuses with pulmonary atresia, severe aortic stenosis and TOF had no significant alterations of Doppler parameters or HC at birth. In fetuses with TGA, mean Z\u2010scores of HC at birth were significantly smaller compared with controls (<jats:italic>mean<\/jats:italic> \u00b1 <jats:italic>SD<\/jats:italic>, \u22120.73 \u00b1 1.25; <jats:italic>P<\/jats:italic> &lt; 0.05), but there was no significant difference in the Doppler parameters. Fetuses with HLH had significantly lower MCA\u2010PI (\u22120.57 \u00b1 0.74; <jats:italic>P<\/jats:italic> &lt; 0.05), MCA\u2010RI (\u22120.73 \u00b1 0.85; <jats:italic>P<\/jats:italic> &lt; 0.05), CPR (\u22121.44 \u00b1 1.05; <jats:italic>P<\/jats:italic> &lt; 0.05) and HC (\u22120.50 \u00b1 1.24; <jats:italic>P<\/jats:italic> &lt; 0.05) <jats:italic>Z<\/jats:italic>\u2010scores compared with controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fetuses with cardiac defects theoretically associated with markedly impaired cerebral oxygen delivery <jats:italic>in utero<\/jats:italic> (TGA and HLH) have smaller HCs at birth. However, only fetuses with HLH have cerebrovascular alterations that are detectable by evaluation of the Doppler indices MCA\u2010PI, MCA\u2010RI and CPR. Copyright \u00a9 2009 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.7474","type":"journal-article","created":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T18:16:25Z","timestamp":1259691385000},"page":"666-672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["Doppler indices of the middle cerebral artery in fetuses with cardiac defects theoretically associated with impaired cerebral oxygen delivery <i>in utero<\/i>: is there a brain\u2010sparing effect?"],"prefix":"10.1002","volume":"34","author":[{"given":"C.","family":"Berg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Gembruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Gembruch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Geipel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,12]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe078138"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2007.12.013"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199503023320901"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(03)00711-6"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.125227"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2008.09.014"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.03.029"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008771"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.103.2.402"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-002-0404-0"},{"key":"e_1_2_5_12_2","first-page":"453","article-title":"Head size at birth in neonates with transposition of great arteries and hypoplastic left heart syndrome","volume":"26","author":"Manzar S","year":"2005","journal-title":"Saudi Med J"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00144842"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70108-4"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.1785"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2002.00756.x"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.045"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2001.00397.x"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1023283"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/00359157740676P113"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199203000-00018"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4088"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-994202"},{"key":"e_1_2_5_25_2","first-page":"249","article-title":"Birthweight of infants with congenital heart disease","volume":"132","author":"Levy RJ","year":"1978","journal-title":"Am J Dis Child"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.25.5.756"},{"key":"e_1_2_5_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-7-4"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-3-3"},{"key":"e_1_2_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2005.12.005"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.911"}],"container-title":["Ultrasound in Obstetrics &amp; 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