USING DOPPLER TO ASSESS THE FETAL HEALTH FOR THE PREDICTION OF GESTATIONAL OUTCOME

2014 ◽  
pp. 9-18
Author(s):  
Thi Linh Giang Truong ◽  
Vu Quoc Huy Nguyen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Functional Method ◽  
Invasive Technique ◽  
Routine Practice ◽  
Fetal Health ◽  
Uterine Arteries ◽  
Non Invasive ◽  
Key Words Doppler

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries

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.

A non-invasive technique for visualization of microvessels in asymptomatic patients with middle cerebral artery steno-occlusion

2013 ◽  
Vol 18 (5) ◽  
pp. 314-317 ◽  
Author(s):  
Yeong-Bae Lee ◽  
Chang-Ki Kang ◽  
Ki-Tae Kim ◽  
Chan-A Park ◽  
Young-Bo Kim ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Invasive Technique ◽  
Non Invasive ◽  
Asymptomatic Patients

scholarly journals Cerebro-umbilical doppler ratio as a predictor of adverse perinatal outcome

2020 ◽  
Vol 9 (2) ◽  
pp. 710
Author(s):  
A. Esther Kamalarani ◽  
Sheba Rosette Victor
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Growth Restriction ◽  
Serial Measurement ◽  
Non Invasive ◽  
Adverse Perinatal Outcome ◽  
Timely Delivery

Background: Intrauterine growth restriction (IUGR) is defined as a subnormal bodyweight or mass in utero. Fetal Doppler studies have been identified as one of the reliable and non-invasive methods of antepartum fetal surveillance in growth-restricted fetuses to detect hypoxemia and to plan timely delivery to precede acidemia. The aim of this study is to evaluate the screening efficacy of the pulsatility indices (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and the ratio of these two indices in predicting the adverse perinatal outcome in pregnancies complicated by IUGR.Methods: In this study patients were included after diagnosed to have fetal growth restriction clinically by a disparity of four weeks or more between symphysis-fundal height and gestational age and on the serial measurement of symphysis-fundal height after 30 weeks of gestation.Results: Out of 100 patients who fulfilled the criteria for the study, only 85 patients delivered. Out of them, only 16 women (18.8%) had a ratio of <1.08 which was considered abnormal and the rest of the women (81.2%) had a ratio >1.08 which was considered normal. The specificity for the Cerebro-umbilical ratio (<1.08) to predict adverse perinatal outcome was 96% whereas that for PI of umbilical A (>1.12) was 83% and that for the PI of middle cerebral A (<1.2) was 84%. However, the sensitivities for these indices were very low.Conclusions: The ratio of the pulsatility indices of the umbilical artery and middle cerebral artery is useful to predict the adverse perinatal outcome.

scholarly journals The Effect of Pregnancy-Induced Hypertension on Uteroplacental Vasculature Hemodynamic Changes and Pregnancy Outcome

2021 ◽  
pp. 211-215
Author(s):  
Fahmida Gul ◽  
Sameena Gul Memon ◽  
Maria Javaid ◽  
Suresh Kumar ◽  
Yaswant Rai ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Color Doppler ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Uterine Arteries ◽  
Induced Hypertension

Background: Among the various complications of pregnancy, pregnancy-induced hypertension is found to be the most common which may affect maternal and fetal outcome. Pregnancy induced hypertension can cause growth retardation of fetus. Aim and Objective: This study aims to assess hemodynamic variations in uteroplacental circulation in pregnancy-induced hypertension and its effect on fetal outcome. Materials and Methods: The study was carried out at tertiary care hospital of nawab shah for the period of 06 months at Department of Radiology in association with Department of Gyne and Obs. Total 106 participants were selected for the study and all females were pregnant with 1st or 2nd trimester gestational record and medical history was taken from all participants and co-morbidities was also evaluated. Blood pressure was checked from all participants from their right arm in lying position and Ultrasound test was repeated as per requirement through color Doppler ultrasound machine and Data was analyzed by using statistical software SPSS. 24.00 version. Results: After collection of research data from all participants, the entire data was assembled for the analysis. Participants were divided into various age groups as 26 were in 18-21yeras, 34 in 22-25years, 21 in 26-29years and only 07 were from 34-37years. 26 participants were belongs to 1st trimester, 34 among 2nd trimester and 21 in third trimester. PI was also noted with three different readings 32 in Umbilical artery, 21 in middle cerebral artery and 37 in uterine artery. RI was also noted among different arteries 41 in umbilical, 36 in middle cerebral and 39 in uterine arteries. S/D was also noted, 33 in umbilical artery, 49 in middle cerebral artery and 30 in uterine arteries. Conclusion: Pregnancy-induced hypertension causes hemodynamic variations in uteroplacental vasculature which may be responsible for causing impaired fetal growth in some cases.

scholarly journals Using pentoxifylline, arginine hydrochloride, levocarnitine and rheosorbilact solutions for correction of fetoplacental dysfunction in pregnant women with preeclampsia

2021 ◽  
Vol 25 (1) ◽  
pp. 88-93
Author(s):  
O. Horbatiuk ◽  
A. Hryhorenko ◽  
A. Shatkovska ◽  
A. Binkovska ◽  
O. Vaskiv ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Main Group ◽  
Controlled Study ◽  
Biological Research ◽  
Uterine Arteries ◽  
Arginine Hydrochloride

Annotation. As of today, there is no effective method for treating the fetoplacental dysfunction (FPD) in pregnant women with preeclampsia. The aim of research was the study of the method proposed by the authors for restoring the functional activity of the fetoplacental complex in pregnant women with FPD on the background of treatment of preeclampsia. А randomized controlled study of the effect proposed treatment (intravenous solution of pentoxifylline; solution containing arginine hydrochloride and levocarnitine; rheosorbilact) of 37 pregnant women at 35-40 weeks of gestation with FPD on the background of moderate preeclampsia, was performed. Such ultrasound doppler measurements have been studied: systolic-diastolic ratio, resistance index, pulsation index in the umbilical arteries, right and left uterine arteries, fetal middle cerebral artery, fetal internal carotid artery and fetal aorta before and after the performed treatment. Statistics were processed using LibreOffice Calc (Mozilla Public License v 2.0), adapted for medical and biological research. We used nonparametric Wilcoxon criteria, Mann-Whitney criteria at a significance level of p <0.05. After the performed treatment, stabilization of the fetoplacental blood circulation in women of the main group was observed, which manifested by decrease in S/D in umbilical artery in 1.3 times, in the left uterine artery in 1.4 times and in the fetal aorta in 1,1 times, and decrease in RI indices in the umbilical artery in 1.1 times, in the right uterine artery in 1.3 times, and increase in the middle cerebral artery in 1.4 times. So, in the course of the proposed treatment, the restoration of the blood flow velocity and the stabilization of vascular resistance in uterine arteries and the umbilical artery were observed in the women of the main group. The research of the possibility of using the above methodology in earlier gestational age and in the risk group for the prevention of preeclampsia is prospective and requires further attention.

scholarly journals The role of sildenafil citrate in the treatment of fetal growth restriction: a randomized controlled trial

2019 ◽  
Vol 8 (5) ◽  
pp. 1840
Author(s):  
Ahmed Abdelshafy ◽  
Khaled Ibrahim Abdullah ◽  
Sherif Ashoush ◽  
Heba E. Hosni
Keyword(s):  
Middle Cerebral Artery ◽  
Fetal Growth ◽  
Cerebral Artery ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Controlled Trial ◽  
Maternity Hospital ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Doppler Velocity

Background: This study was aimed to evaluate the effect of sildenafil citrate on Doppler velocity indices in patients with fetal growth restriction (FGR) associated with impaired placental circulation.Methods: A double-blinded, parallel group randomized clinical trial (clinicaltrials.gov NCT02590536) was conducted in Ain Shams Maternity Hospital, in the period between October 2015 and June 2017. Ninety pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were randomized to either sildenafil citrate 25 mg orally every 8 hours or placebo visually-identical placebo tablets with the same regimen. The primary outcome of the study was the change in umbilical artery and fetal middle cerebral artery indices.Results: There was a significant improvement in umbilical and middle cerebral artery indices after sildenafil administration p<0.001. Present study observed that, sildenafil group, in comparison to placebo, has a significantly higher mean neonatal birth weight. 1783±241g vs 1570±455g (p<0.001). There was a significantly higher mean gestational age at delivery in women in sildenafil group 35.3±1.67 weeks, whereas it was lower in the placebo group 33.5±1.7 weeks. The side effects as headache, palpitation and facial flushing were significantly higher in sildenafil group compared to placebo group.Conclusions: The use sildenafil citrate in pregnancies with fetal growth restriction (FGR) improved the feto-placental Doppler indices (pulsatility index of umbilical artery and middle cerebral artery) and improved neonatal outcomes.

scholarly journals Differences in Biometric Fetal Weight Estimation Accuracy and Doppler Examination Results in Uncomplicated Term Singleton Pregnancies between Vertex and Breech Presentation

2021 ◽  
Vol 10 (15) ◽  
pp. 3252
Author(s):  
Lukas Jennewein ◽  
Simon Theissen ◽  
Hemma Roswitha Pfeifenberger ◽  
Nadja Zander ◽  
Kyra Fischer ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Breech Presentation ◽  
Fetal Weight ◽  
Estimation Accuracy ◽  
Weight Estimation ◽  
Fetal Weight Estimation ◽  
Presentation Group ◽  
Chi2 Test

Doppler examination of the umbilical artery and the fetal middle cerebral artery is evaluated predominantly in pregnancies with fetuses in cephalic presentation and never has been elucidated in breech presentation. Evidence on the accuracy of fetal weight estimation in dependence of the fetal presentation is controversial. Nevertheless, clinical decisions including recommendations for a cesarean section or labor induction based on these examinations are applied to pregnancies with fetuses in breech presentation. The objective of this study was to investigate the influence of the fetal presentation on fetal weight estimation accuracy, umbilical artery and middle cerebral artery resistance indices (RI) in a prospective case control study. Ultrasound examinations in 305 uncomplicated term pregnancies (153 vertex presentations, 152 breech) were investigated. Non-parametric variables were compared using Pearson’s chi2 test and Wilcoxon chi2 test, depending on variable scaling. Fetal weight estimation accuracy was not significantly different between vertex presentation group (VP) (6.97%) and breech presentation group (BP) (7.96%, p = 0.099). Fetal head circumference measurements were significantly larger in BP (350 mm vs. 341 mm in VB, p > 0.0001) while abdominal circumferences were significantly smaller (VP: 338 mm, BP: 331 mm, p = 0.0039) and weight estimation was not significantly different. Umbilical artery RIs were not significantly different between VP (54.5) and BP (55.3, p = 0.354). Fetal middle cerebral artery RIs also showed no significant differences (VP: 71.2, BP: 70.7, p = 0.335). Our study shows that fetal Doppler (RI) and weight estimation ultrasound originally calibrated in cephalic pregnancies are applicable to pregnancies with fetuses in breech presentation.

scholarly journals Doppler ultrasound in pregnancy – quality requirements of DEGUM and clinical application (part 2)

2021 ◽  
Author(s):  
Renaldo Faber ◽  
Kai-Sven Heling ◽  
Horst Steiner ◽  
Ulrich Gembruch
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Prophylactic Treatment ◽  
Doppler Sonography ◽  
First Trimester ◽  
Ductus Venosus ◽  
Fetal Diagnosis

AbstractThis second part on Doppler sonography in prenatal medicine and obstetrics reviews its clinical applications. While this has not become the initially anticipated screening tool, it is used for the diagnosis and surveillance of a variety of fetal pathologies. For example, the sonography-based determination of uterine artery blood flow indices is an important parameter for the first trimester multimodal preeclampsia risk assessment, increasing accuracy and providing indication for the prophylactic treatment with aspirin. It also has significant implications for the diagnosis and surveillance of growth-restricted fetuses in the second and third trimesters through Doppler-sonographic analysis of umbilical artery, middle cerebral artery and ductus venosus. Here, especially the hemodynamics of the ductus venosus provides a critical criterium for birth management of severe, early-onset FGR before 34 + 0 weeks of gestation. Further, determination of maximum blood flow velocity of the middle cerebral artery is a central parameter in fetal diagnosis of anemia which has been significantly improved by this analysis. However, it is important to note that the mentioned improvements can only be achieved through highest methodological quality. Importantly, all these analyses are also applied to twins and higher order multiples. Here, for the differential diagnosis of specific complications such as TTTS, TAPS and TRAP, the application of Doppler sonography has become indispensable. To conclude, the successful application of Doppler sonography requires both exact methodology and precise pathophysiological interpretation of the data.

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