The Effect of Antenatal Vaginal Progesterone Administration on Uterine, Umbilical, and Fetal Middle Cerebral Artery Doppler Flow: A Cohort Study

2019 ◽  
Vol 37 (05) ◽  
pp. 491-496
Author(s):  
Ahmed M. Maged ◽  
Amira Y. Shoab ◽  
Eman A. Hussein ◽  
Ahmed H. Alsawaf ◽  
Doaa S. Mahmoud ◽  
...  

Abstract Objective This study aimed to evaluate the effect of vaginal progesterone (P) administration during the second and third trimesters of pregnancy on Doppler velocimetry of uterine, umbilical, and middle cerebral vessels. Study Design A prospective cohort study conducted on 80 women at risk for preterm labor. Uterine artery, umbilical artery, and middle cerebral artery (MCA) Doppler indices were measured before and after 1 week of administration of 200 mg twice daily vaginal P. The primary outcome parameter was the change of MCA pulsatility index (PI) after P administration. Secondary outcomes included changes in uterine artery and umbilical artery Doppler measurement. Results There was no significant changes of umbilical artery resistance index (RI) (0.69 ± 0.049 vs. 0.68 ± 0.041), umbilical artery PI (1.14 ± 0.118 vs. 1.11 ± 0.116), uterine artery RI (0.66 ± 0.12 vs. 0.66 ± 0.107), uterine artery PI (1.00 ± 0.26 vs. 1.016 ± 0.24), and MCA PI (1.27 ± 0.18 vs. 1.26 ± 0.23) measurements before and after 1 week of P administration, respectively. Conclusion Administration of vaginal P has no significant effects on uterine artery, umbilical artery, and MCA Doppler indices.

2012 ◽  
Vol 2 (2) ◽  
pp. 77-80
Author(s):  
Md Abu Taher ◽  
Nuzhat Tasmin ◽  
AS Mohiuddin ◽  
Md Mohit Ul Alam ◽  
Md Mofazzal Sharif ◽  
...  

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


2015 ◽  
Vol 49 (3) ◽  
Author(s):  
Sara Mugerli ◽  
Gordana Njenjić ◽  
Vesna Fabjan Vodušek ◽  
Miha Lučovnik

Introduction: Maternal abdominal decompression during pregnancy could be used in an attempt to improve utero-placental blood flow. We utilized Doppler ultrasonography to investigate the effects of this procedure on blood flow in the umbilical artery and fetal middle cerebral artery. Methods: Women (n = 23) with singleton pregnancies attending antenatal abdominal decompression were enrolled in the study. Doppler velocity waveforms were obtained from umbilical artery and fetal middle cerebral artery before and after a 30-minute decompression session. Resistance indices were compared using the Student's t - test (p < 0.05 significant). Results: 23 healthy pregnant women were included at an average gestational age of 36+1 weeks. The mean resistance index before decompression in the umbilical artery was 0.58 (s = 0.10) and after decompression 0.54 (s = 0.07, p = 0.06). In the middle cerebral artery the values were 0.72 (s = 0.11) and 0.77 (s = 0.08), respectively (p = 0.01). Discussion and conclusion: Significantly increased resistance index in the middle cerebral artery implies a higher fetal brain oxygenation after decompression. This is further corroborated by the trend towards a decrease in umbilical artery resistance index. The effects of decompression could be beneficial in pregnancies complicated by IUGR or hypertensive disorders of pregnancy.


1970 ◽  
Vol 32 (3) ◽  
pp. 5-13
Author(s):  
S Paudel ◽  
B Lohani ◽  
G Gurung ◽  
MA Ansari ◽  
P Kayastha

Introduction: The purpose of this study was to categorize new reference ranges for measurements of commonly used umbilical artery and fetal middle cerebral artery Doppler indices (Pulsatility Index, Resistance Index, and Systolic: Diastolic ratio) in uncomplicated third trimester pregnancy. Methods: This was a prospective cross sectional study involving 101 singleton uncomplicated pregnancies of 30 to 37 weeks of gestation. Umbilical artery indices were obtained from free floating loop and middle cerebral Doppler indices were obtained from the proximal third of the artery with flow towards the probe. Regression equations were used to categorize reference ranges and percentile fitted Normograms were obtained for all the parameters. Results: Among 101 singleton pregnancies between 30 and 37 weeks of gestation, 65 (64.35%) were primigravida women and 36 (34.65%) were multigravida. Mean maternal age was 23.12years (range 16 to 35 years). Maximum number of pregnancies (18.81%) was at 34 weeks of gestation. The established percentiles of Doppler indices showed a continuous reduction of all the measured indices as pregnancy increases (p<0.0001). Conclusions: Reference ranges were obtained for the middle cerebral artery and umbilical artery Doppler indices. These ranges are consistent with similar studies done by other authors. Keywords: Doppler study; fetal Middle cerebral artery; pulsatility index; resistance index; systolic; diastolic ratio; umbilical artery DOI: http://dx.doi.org/10.3126/joim.v32i3.4953 Journal of Institute of Medicine, December, 2010; 32:3 5-13


Author(s):  
M.V. Medvedev, N.A. Altynnik

This article discusses issues of screening and comprehensive Doppler ultrasonography in the second part of gestation including assessment of the uterine artery, umbilical artery, fetal middle cerebral artery and ductus venosus waveforms.


2021 ◽  
pp. 875647932110519
Author(s):  
Zara Jabeen ◽  
Raham Bacha ◽  
Zain-ul-Hassan ◽  
Mehreen Fatima ◽  
Iqra Manzoor ◽  
...  

Objective: The objective of this study was to determine the hemodynamic changes in the umbilical artery (UA) and middle cerebral artery (MCA) with oligohydramnios, during third trimester of pregnancy. Materials and Methods: A cross-sectional descriptive study was done in a perinatal ultrasound center, over a 9-month period. The participant sample size was 64, and all of the women were conveniently consented and selected for the study. All individuals were referred for obstetrical sonography in the third trimester, with oligohydramnios. All fetal anomalies, such as a neural tube defect, dwarfism, an abdominal wall defect, were excluded from the study. Results: The mean systolic to diastolic (S/D) ratio for the UA was 3.01, within a range of 1.49 to 5.60 (± 0.79 SD). The mean pulsatility index (PI), of the UA, was 1.11, within a range of 0.41 to 5.51 cm (± 0.64 SD). The mean resistive index (RI) of the UA was 0.66, within a range of 0.33 to 1.25 cm (± 0.13 SD). The mean S/D ratio of the MCA was 5.68, within a range of 2.05 to 26.10 (± 3.10 SD). The mean PI of the MCA was 1.67 within a range of 0.75 to 2.55 cm (± 0.45 SD). The mean resistive index (RI), of the UA, was 0.82 within a range of 0.51 to 1.77 cm (± 0.82 SD). Conclusion: The Doppler indices may rise as pregnancy advances, especially in fetuses with oligohydramnios. In these types of patients, the flow within the MCA may decrease, with an increase in the gestational age. Consequently, it appears that oligohydramnios may lead to vascular remodeling of the UA and MCA.


Author(s):  
Nazanin Farshchian ◽  
Mozhdeh Hajsafarali ◽  
Negin Farshchian ◽  
Parisa Bahrami Kamangar

Chorionic villus sampling (CVS) is an invasive method for identifying genetic and metabolic diseases, which is done in the first trimester of pregnancy and can cause many complications. The aim of this study is the evaluation of the correlation between Transabdominal chorionic villus sampling and fetal distress in color Doppler sonography. This study is experimental (before and after). All pregnant women with minor thalassemia in which their husbands were suffering from minor thalassemia or have a history of a child with major thalassemia and after the 12th week of pregnancy were referred to the ultrasound department. RI for fetal Middle Cerebral Artery (MCA) and Umbilical Artery (UA) before and after of CVS were measured and then statistically analyzed using SPSS 22. CVS did not cause a significant increase in RI for the fetal middle cerebral artery (P>0.05). CVS did cause a significant increase in RI for the umbilical artery (P<0.05). Then, CVS did cause a significant decrease in the ratio of RI for fetal Middle Cerebral Artery to RI for Umbilical Artery (P<0.05). Based on these results, it seems that CVS can cause distress in the fetus.


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