Hemodynamic Changes in Umbilical Artery and Middle Cerebral Artery With Oligohydramnios in Third Trimester of Pregnancy

2021 ◽  
pp. 875647932110519
Author(s):  
Zara Jabeen ◽  
Raham Bacha ◽  
Zain-ul-Hassan ◽  
Mehreen Fatima ◽  
Iqra Manzoor ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Abdominal Wall Defect ◽  
Resistive Index ◽  
Third Trimester ◽  
Hemodynamic Changes ◽  
Cross Sectional ◽  
The Mean ◽  
Doppler Indices

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.

scholarly journals Reference values for Doppler indices of the umbilical and fetal middle cerebral arteries in uncomplicated third trimester pregnancy

1970 ◽  
Vol 32 (3) ◽  
pp. 5-13
Author(s):  
S Paudel ◽  
B Lohani ◽  
G Gurung ◽  
MA Ansari ◽  
P Kayastha
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Pulsatility Index ◽  
Umbilical Artery ◽  
Resistance Index ◽  
Reference Ranges ◽  
Regression Equations ◽  
Third Trimester ◽  
Trimester Pregnancy ◽  
Doppler Indices

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

scholarly journals Nomogram of Umbilical, Mean Cerebral and Uterine Arteries Resistive Index at 28 – 40 Weeks of Gestation in Cameroonian Population: A Pilot Study

2020 ◽  
Author(s):  
Boniface MOIFO ◽  
Ulrich Gael TENE ◽  
Carine NJOMATCHOUA ◽  
Jean Roger MOULIOM TAPOUH ◽  
Pascal FOUMANE
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Gestational Age ◽  
Umbilical Artery ◽  
Resistive Index ◽  
Low Risk ◽  
Biomedical Sciences ◽  
Singleton Pregnancy ◽  
Uterine Arteries ◽  
Fetal Doppler

Abstract Background: Mother and fetal Doppler ultrasound during pregnancy is an established and safe tool for quantitative analysis of the utero-placental and the fetoplacental blood flow and seems to be affected by Ethnic hetérogenicity. Objective. To establish normative data for the resistive index of Uterine arteries, Umbilical artery and middle cerebral artery of Cameroonian pregnant women in the second half of pregnancy using multiples of the median and percentile reference range.Methods. We conducted a cross-sectional study on 93 low risk singleton gestation women aged above 18 years between 28 and 39 weeks of gestation in two hospitals in Cameroon during 7 months. We seek for resistive index (RI) of both left and right uterine arteries (LUt and RUt), Umbilical artery (UmA) and Middle cerebral artery (MCA). We also estimated the gestational age (GA), the mother age, the fetal weight (EFW) and the cerebro – placental ration (CPR).Pearson's correlation analysis of the relationship between these RI and selected maternal parameters was done. Regression modeling across gestational age was performed to obtain the reference values and normogram curve with values ranged at 5 and 95th percentiles. P < 0.05 was considered statistically significant.Results. The mean GA and EFW was 33.5 +/- 2.92 weeks (médian of 34) and 2337.5 +/- 734 g respectively. The means RI value of target vessels were 0.55 +/- 0.077; 0.76 +/- 0.071 ; 0.48 +/- 0.077 and 0.46 +/-0.087 for UmA, McA, RUt and LUt with extremes values of des 0.38 to 0.77 ; 0.49 to 0.87; 0.30 to 0.70 and 0.29 to 0.69 respectively. Only UmA RI and CPR values had shown correlations with GA (r= - 0.338, p≤0.01 and r=0.314; p≤0.001) and EFW (r=-0.445, p≤0.001 and r=0.234; p = 0.02). No difference between LUt and RUt RI values was found. The nomogram curve for UmA, McA, RUt and LUt value revealed a general low RI values of in our sample.Conclusions. Fetal Doppler should carefully interpreted according to general low RI values during low risk singleton pregnancy shown by this study. The generated 5and 95th percentiles RI values curves for each target vessel could be useful in that way.Trial registration:N°431/UY1/FMSB/VDRC/CSD du 24 mai 2017 by the Institutional Review Board at the faculty of Medicine and Biomedical Sciences of University of Yaoundé 1.

scholarly journals Normal value of pulsatility index of umbilical artery in second and third trimester of pregnancy

2013 ◽  
Vol 39 (1) ◽  
pp. 42-44 ◽  
Author(s):  
MA Ferdous ◽  
MM Sharif ◽  
AS Mohiuddin ◽  
F Shegufta
Keyword(s):  
Gestational Age ◽  
Pulsatility Index ◽  
Umbilical Artery ◽  
Negative Relationship ◽  
Cross Sectional Study ◽  
Third Trimester ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean ◽  
Level Of Significance

This cross sectional study was carried out on 60 pregnant Bangladeshi women in the department of Radiology and Imaging, BIRDEM for measurement of Pulsatility Index (PI) of umbilical artery of their fetuses by duplex colour Doppler sonography during 2nd and 3rd trimester of pregnancies. Considering total 2nd and 3rd trimesters the mean PI value of umbilical artery was 1.24 (SD±0.27). While considering the gestational in separate trimesters, study showed that the value of PI in 2nd trimester was 1.33 (SD±0.29) and in 3rd trimester PI was 1.18 (SD±0.25). Paired t test shows there was a highly significant (t=35.79, df=59, Level of significance=0.001) difference between mean values of PI in different gestational ages. It was observed that there was gradual decrease of PI value with increase of gestational age (r= -0.207) but this decrease of PI was not statistically significant (p=0.113). Regression analysis between dependent PI value and independent gestational age showed linear negative relationship but this was not statistically significant (p=0.11). This study revealed that the Pulsatility index of umbilical artery was decreased with increase of gestational age from 2nd to 3rd trimester. DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15809 Bangladesh Med Res Counc Bull 2013; 39: 42-44

Association Between Fetal Thymus Size and Intrauterine Growth Restriction

2021 ◽  
pp. 875647932110547
Author(s):  
Elham Keshavarz ◽  
Marjan Rustazade Sheikhyusefi ◽  
Ensi Khalili Pouya ◽  
Masoumeh Mirzamoradi ◽  
Mehdi Khazaei ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intrauterine Growth Restriction ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Control Group ◽  
Fetal Thymus ◽  
Intrauterine Growth ◽  
The Mean ◽  
Thymus Size

Objective: The objective of this study was to evaluate the association between reduced fetal thymus size and intrauterine growth restriction (IUGR). This study was devised to determine the association between thymus size and any abnormal Doppler indices within the fetal umbilical artery (UA), as well as the middle cerebral artery (MCA). Materials and Methods: Forty-six pregnancies between 20 and 38 weeks of gestation with IUGR and 46 normal pregnancies within similar gestational age (GA) range were included. The transverse diameter of fetal thymus was measured. In the IUGR group, the fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler flow velocities were recorded. Results: The mean GA of fetuses with IUGR (33.5 weeks) was higher than control group (30.3 weeks). To adjust for the effect of GA, analysis of covariance (ANCOVA) was performed. The adjusted mean thymus diameters were 19.02 mm in IUGR and 21.25 within the control group (mean difference = 2.23 mm; P = .02). The mean (±SD) thymus size in 16 fetuses, with abnormal Doppler findings, was significantly lower than in the group with normal Doppler findings, 17.45 (±2.50) vs 22.02 (±5.39) mm; P < .001. Conclusion: IUGR may be associated with reduced fetal thymus size, especially when coupled with abnormal Doppler findings. The thymus size in a group of IUGR fetuses, with abnormal Doppler findings, was smaller than IUGR fetuses, with normal Doppler findings.

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 ◽  
...  
Keyword(s):  
Cohort Study ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Resistance Index ◽  
Doppler Measurement ◽  
Vaginal Progesterone ◽  
Before And After ◽  
Doppler Indices

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.

scholarly journals The Role of The Doppler Study (Umbilical, Middle, Cerebral Arteries and Ductus Venosus) to Predict General Adverse Pregnancy Outcomes in Patients With Hypertensive Diseases in The Third Trimester

2021 ◽  
Vol 21 (2) ◽  
pp. 10-21
Author(s):  
Ahmed Majid Salman ◽  
◽  
Mohammed A.K. Al-Jiboori ◽  
Hadeel Qasim Khaleel ◽  
Enas Adnan
Keyword(s):  
Pregnant Women ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Hypertensive Disorder ◽  
Third Trimester ◽  
The Third ◽  
Doppler Study ◽  
Adverse Pregnancy

Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes. Keywords: Hypertensive disorder, Middle cerebral artery, Umbilical artery, Ductus venosus

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