Fetal myocardial tissue Doppler indices before birth physiologically change in proportion to body size adjusted for gestational age in low-risk term pregnancies

Background: One of the consequences of IUGR is the development of cardiac diastolic dysfunction in fetuses. Tissue doppler in echocardiography is a new technique to detect myocardial tissue function and can act as a useful tool in the identification of this complication. Hence we decided to undertake this study to assess the utility of myocardial tissue doppler in detecting foetal cardiac dysfunction in IUGR. It was a prospective case control study in a tertiary care teaching hospital.Methods: Foetal cardiac function in the third trimester of pregnancy was evaluated with the help of myocardial tissue doppler and compared between IUGR and normal growth babies and correlated with vessel doppler findings and neonatal outcomes.Results: There were sixty two IUGR and fifty eight normal growth babies in the study. In babies with IUGR, particularly the ones with severe IUGR, abnormal vessel doppler and adverse neonatal outcomes, right ventricular MPI was found to be significantly lower. However, the variable had a poor sensitivity (40%) in detecting fetuses at risk for poor neonatal outcomes.Conclusions: Myocardial tissue doppler shows right sided cardiac dysfunction in IUGR babies in comparison to normal growth babies It is however not a sensitive indicator of adverse perinatal outcome in IUGR babies.

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Doppler Flow Velocity Indices (RI, PI, S/D & PSV) of Fetal Middle Cerebral Artery in Normal Pregnancies: Correlation with Gestational Age of 20 to 40 Weeks

BIRDEM Medical Journal ◽

10.3329/birdem.v2i2.12306 ◽

2012 ◽

Vol 2 (2) ◽

pp. 77-80

Author(s):

Md Abu Taher ◽

Nuzhat Tasmin ◽

AS Mohiuddin ◽

Md Mohit Ul Alam ◽

Md Mofazzal Sharif ◽

...

Keyword(s):

Middle Cerebral Artery ◽

Flow Velocity ◽

Cerebral Artery ◽

Gestational Age ◽

Resistance Index ◽

Peak Systolic Velocity ◽

Doppler Flow ◽

Significant Difference ◽

Before And After ◽

Doppler Indices

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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