Peak systolic velocity Doppler of middle cerebral artery in small for gestational age (SGA) fetus

This observational type of descriptive study was carried out in the Department of Radiology and Imaging, BIRDEM selecting 70 Bangladeshi pregnant babies with the aim to find out the normogram of foetal middle cerebral artery Doppler flow velocity indices and correlation between Doppler flow velocity indices [Resistance Index (RI), Pulsatility Index (PI), Systolic/Diastolic ratio (S/D) & Peak Systolic Velocity (PSV)] of foetal middle cerebral artery and gestational age in normal pregnancies of 20 to 40 weeks. It was observed that RI, PI and S/D were decreased with the advance of gestational age but PSV was increases with the advance of gestational age. Statistical analyses showed there were significant difference between mean PSV, RI and PI before and after 25 weeks of gestation. No significant difference was found between mean S/D before and after 25 weeks of gestation. It was observed from Correlation analysis between Doppler indices with independent gestational age that all the Doppler indices of foetal middle cerebra artery was positively correlated with the whole gestation period. The statistical analysis showed only PSV and RI were significantly correlated with the gestational age. Simple regression analysis between dependent Doppler index with independent gestational age before and after 25 weeks revealed that all the Doppler indices had positive relationship with the corresponding gestational age but relationship between PSV and PI (before 25 weeks) with their corresponding gestational ages were only statistically significant.DOI: http://dx.doi.org/10.3329/birdem.v2i2.12306 Birdem Med J 2012; 2(2) 77-80

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Reference Values of Fetal Peak Systolic Velocity in the Middle Cerebral Artery at 19–40 Weeks of Gestation in Nepalese Population

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v8i2.9769 ◽

2014 ◽

Vol 8 (2) ◽

pp. 42-45 ◽

Cited By ~ 1

Author(s):

U Shrestha ◽

I Shrestha ◽

RK Ghimire ◽

S Paudel

Keyword(s):

Middle Cerebral Artery ◽

Cerebral Artery ◽

Gestational Age ◽

Adverse Pregnancy Outcome ◽

Peak Systolic Velocity ◽

Cross Sectional Study ◽

Cross Sectional ◽

Systolic Volume ◽

Serial Measurement ◽

Adverse Pregnancy

Aims: The purpose of this study was to construct new reference range for fetal middle cerebral artery peak systolic velocity (MCA-PSV) in uncomplicated pregnancy at 19-40 weeks of gestation. Methods: This was a prospective cross-sectional study involving 400 singleton pregnancies between 19 and 40 weeks of gestation without any known risk factors of adverse pregnancy outcome who were referred for routine obstetric examination. The protocol included the doppler examination of fetal middle cerebral artery (MCA) within 2 mm after its origin from the internal carotid artery and data were used to construct the normograms and percentile fitted curves of each doppler parameter for different gestational age. Results: Among 400 singleton uncomplicated pregnancies between 19 and 40 weeks of gestation maximum number of pregnancies (10%) was at 19 weeks of gestation and minimum (2.5%) was at 31 weeks. The fetal peak systolic blood flow in the MCA showed significant correlation with period of gestation. Mean MCA-PSV was 22.35 ± 3.05 at 19 weeks of gestation which increased to 67.73 ± 9.92 at 40 weeks. The MCA-PSV showed continuous increment with increasing gestational age.Conclusions: Continuous increment in the peak systolic volume with advancing gestational age was obtained which was consistent with the previous studies done by various authors. The percentile fitted values and normograms will be valuable for the serial measurement of the peak systolic volume of the middle cerebral artery for complicated pregnancies.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 42-45 DOI: http://dx.doi.org/10.3126/njog.v8i2.9769

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Comparison of the Performances of Middle Cerebral Artery Peak Systolic Velocity and Cardiothoracic Diameter Ratio in Predicting Fetal Anemia: Using Fetal Hemoglobin Bart’s Disease as a Study Model

Fetal Diagnosis and Therapy ◽

10.1159/000519543 ◽

2021 ◽

pp. 1-8

Author(s):

Wisit Chankhunaphas ◽

Theera Tongsong ◽

Fuanglada Tongprasert ◽

Kasemsri Srisupundit ◽

Suchaya Luewan ◽

...

Keyword(s):

At Risk ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Gestational Age ◽

Peak Systolic Velocity ◽

Fetal Hemoglobin ◽

Diameter Ratio ◽

Fetal Anemia ◽

Receiver Operating Characteristic Curves ◽

Hb Bart's

Objective: The aim of the study was to compare the performances of cardiothoracic diameter ratio (CTR) and middle cerebral artery peak systolic velocity (MCA-PSV) in predicting fetal hemoglobin (Hb) Bart’s disease and identify the best CTR cut-off for each gestational period. Methods: Pregnancies at risk of fetal Hb Bart’s disease (gestational ages of 12–36 weeks) were prospectively recruited to undergo ultrasound examination. The measurements of CTR and MCA-PSV were performed and recorded before invasive diagnosis. Results: During the study period (2005–2019), a total of 1,717 pregnancies at risk of fetal Hb Bart’s disease met the inclusion criteria and were available for analysis, including 329 (19.2%) fetuses with Hb Bart’s disease. The mean gestational age at the time of diagnosis was 19.30 ± 5.6 weeks, ranging from 12 to 36 weeks. The overall performance of CTR Z-scores is superior to that of MCA-PSV multiple of median (MoM) values; area under curve of 0.866 versus 0.711, p value <0.001. The diagnostic indices of CTR and MCA-PSV are increased with gestational age. Based on receiver operating characteristic curves of CTR Z-scores, the best cut-off points of CTR at 12–14, 15–17, 18–20, 21–23, and ≥24 weeks are 0.48, 0.49, 0.50, 0.51, and 0.54, respectively. The best cut-off of MCA-PSV is 1.3 MoM, giving the best performance at 21–23 weeks with a sensitivity of 91.8% and specificity of 85.5%. Conclusion: The performance of CTR is much better than MCA-PSV in predicting fetal anemia caused by Hb Bart’s disease. Nevertheless, whether this can be reproduced in anemia due to other causes, like isoimmunization, is yet to be explored.

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Middle Cerebral Artery Doppler Changes following Fetal Transfusion Performed with and without Fetal Anesthesia

American Journal of Perinatology ◽

10.1055/s-0037-1613683 ◽

2017 ◽

Vol 35 (07) ◽

pp. 682-687 ◽

Cited By ~ 1

Author(s):

Kristen Uquillas ◽

Myrna Aboudiab ◽

Lisa Korst ◽

Arlyn Llanes ◽

Brendan Grubbs ◽

...

Keyword(s):

Middle Cerebral Artery ◽

Umbilical Cord ◽

Cerebral Artery ◽

Gestational Age ◽

Peak Systolic Velocity ◽

Fetal Anemia ◽

Intravenous Anesthesia ◽

Intrauterine Transfusion ◽

The Difference ◽

The Relationship

Objective The objective of this study was to test the association between fetal intravenous anesthesia and the change in middle cerebral artery peak systolic velocity (MCA-PSV) in patients undergoing intrauterine transfusion (IUT) for suspected fetal anemia. Study Design We retrospectively examined data from all patients who underwent IUT via umbilical cord route from 2007 to 2016. We calculated the change of the MCA-PSV multiple of median (MoM) as the difference in MCA-PSV MoM between the pre- and immediate postoperative measurements for the first IUT. The change in MCA-PSV MoM was compared between those who did and did not receive fetal anesthesia using Kruskal–Wallis' testing. Results Of 62 patients, 37 (59.7%) received intravenous fetal anesthesia and 25 (40.3%) did not. The change in MCA-PSV MoM did not differ between those who did and did not receive fetal anesthesia (median: 0.57 [interquartile range, IQR: +0.42 to +0.76] vs. median 0.57 [IQR: +0.40 to +0.81], p = 1.000). The relationship remained insignificant when stratifying by gestational age, length of procedure, initial MCA-PSV, and when excluding hydropic fetuses. Conclusion Among women undergoing IUT, there was no evidence that the use of fetal anesthesia was associated with a change in the pre- versus postoperative change in MCA-PSV MoM.

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