Perinatal preterm brain injury. Risk assessment, antenatal surveillance and managing

This work reports the results of two different lines of research: 1. On the employment of ultrasound in the management of fetuses with intra-uterine growth restriction (IUGR); 2. On management of preterm birth for prevention of neurological impairment in high-risk pregnancies and low risk pregnancies. Pre-natal flow data and post-natal neurological outcome in IUGR fetuses have been evaluated. Doppler ultrasound in obstetrics has allowed the detection of the early signs of fetal demise, involving the management of pregnancies at risk of fetal hypoxia. The second line of research focuses on the need to identify strategies to predict preterm birth in asymptomatic low-risk women as well as in those presenting with threatened preterm labor (symptomatic high risk women) and underlines the importance to prevent brain injury and long-term neurological sequelae related to preterm deliveries. Neurological insults result in significant immediate and longterm physical, emotional, and financial costs. Advances in obstetrical and neonatal care have led to survival at earlier gestational ages and consequently increasing numbers of periviable infants who are at significant risk for long-term neurological deficits. Therefore, efforts to decrease and prevent cerebral insults attempt not only to improve neurological outcomes in infants delivered preterm but also primarily to decrease preterm delivery.