Cerebral artery blood flow velocity waveforms in normal and small for dates fetuses.

Ishimatsu, Junji; Hotta, M.; Matsunaga, Takamoto; Manabe, Akihiro; Yoshimura, Osamu; Tetsuou, M.; Hamada, Teiji; Yakushiji, M

doi:10.2739/kurumemedj.36.181

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…Changes in the RI of the cerebral artery appear to be more pronounced than those of the umbilical artery during pregnancy. Intrauterine growth retardation, fetal distress, hypertensive disease or toxemia have been associated with elevations in the pulsatility index, RI and SID ratio in the umbilical artery (Erskine and Ritchoe, 1985;Trudinger et al 1985;Wladimiroff et al 1986), as well as a decrease in the RI of the cerebral artery (Arbeille et al 1987;Ishimatsu et al 1989).…”

Section: Discussionmentioning

confidence: 99%

Blood Flow Velocity Waveforms of the Fetal Middle Cerebral Artery in Pregnancies Complicated by Diabetes Mellitus.

et al. 1995

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Section: Discussionmentioning

confidence: 99%

Blood Flow Velocity Waveforms of the Fetal Middle Cerebral Artery in Pregnancies Complicated by Diabetes Mellitus.

et al. 1995

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“…Changes in the RI of the cerebral artery appear to be more pronounced than those of the umbilical artery during pregnancy. IUGR, fetal distress, fetal hypertensive disease or toxemia have been associated with elevations in the PI, RI and S/D ratio in the umbilical artery, as well as a decrease in the PI, RI of the cerebral artery [15].…”

Section: Middle Cerebral Artery Doppler (Mca)mentioning

confidence: 99%

Study of Maternal and Fetal Doppler Velocimetry, Histopathology of Placental Bed in Diabetic Pregnancy and Its Correlation to Fetal Outcome

Matar¹

2021

JWHCI

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Diabetes mellitus still represents an important medical problem during pregnancy, causing perinatal morbidity and mortality. Despite improved outcome reflected by a steep decline in perinatal mortality over the past few decades, controversy still exists regarding the care of the pregnant woman with both pre-existing and gestational Diabetes Mellitus. Doppler ultrasound is especially valuable during pregnancy because fetal maternal and placental circulations can be studied. The aim of this work was to study the vascular changes in the uteroplacental and fetoplacental circulations, and to correlate these findings with histopathology of the placenta and placental bed, which may occur in association with diabetic pregnancies. The study was carried out on 100 pregnant women of comparable age and parity. They were divided into 2 groups. The control group comprising 20 normal non-diabetic pregnant women and the normotensive diabetic group comprising 80 pregnant diabetic women. All were singleton pregnancies of 34 weeks or more and were delivered by C.S the control and the study cases were subjected to history taking and thorough physical examination. They were also subjected to ultrasonographic examination for fetal biometric parameters and for Doppler examination. Doppler examination included umbilical artery, uterine arteries fetal middle cerebral artery. At the time of C.S the placenta and placental bed biopsy was obtained. After delivery, the Apgar score of the newborn was assessed at 1 and 5 minutes, the body weight was measured, and the fetus was followed up for any complications. Result: There was a positive correlation between the umbilical artery PI and the mean blood glucose levels indicating that poor diabetic control is probably associated with increased umbilical artery PI. However, there was no significant difference between the mean value of the umbilical artery PI in the diabetic and control groups. The uterine arteries Doppler indices showed no significant findings between the diabetic and the control groups. Neither did the uterine arteries Doppler indices show a correlation with the mean blood glucose levels. There was no significant difference between the middle cerebral artery PI in the diabetic and control groups. This observation indicates that there was no redistribution in the fetal circulation in the fetuses of the diabetic group. There was also non correlation between the MCA Doppler indices and the glycemic control. Histopathologic studies of the placental bed showed marked difference between the diabetic group and the control group as regards lack of physiologic changes and arteriosclerotic changes, which emphasizes the effect of diabetes on the placental bed vasculature. Conclusion: Abnormal umbilical artery waveform analysis is one of significant predictors of fetal compromise in diabetic pregnancy, but fetal compromise can occur in association with normal Doppler waveform analysis. In maternal diabetes the classic redistribution seen in fetal hypoxemia due to uteroplacental insufficiency may not occur in diabetic patient even in severely compromised fetuses. In maternal diabetes mellitus, maternal glycemic control has no effect on impedance to flow in the uterine and middle cerebral arteries. No relationship was found between the uterine or umbilical arteries Doppler indices and the placental bed decidual vascular pathology in diabetic pregnancies. There was no correlation between placental findings and the Doppler waveform analysis of the umbilical and the uterine arteries.

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“…Following initial reports of altered fetal cerebral hemodynamics in at-risk fetuses, conflicting results emerged regarding the association between the MCA Doppler changes and poor fetal condition. Some reported increased cerebral resistance indices 117 whilst others reported no difference. 118 However, further reports have confirmed that whilst the MCA pulsatility may not be reduced in all small for gestational age (SGA) fetuses, reduced MCA pulsatility is associated with poorer perinatal outcomes, 119 including IFC, [120][121][122] low Apgar score, 123 neonatal acidosis, 123 neonatal intensive care unit admission 120 and low birth weight.…”

Section: Umbilical Arterymentioning

confidence: 99%

Prediction of fetal distress

Bligh¹

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Introduction: Identification of the increased risk of intrapartum fetal compromise prior to labour is an obstetric challenge. Globally, intrapartum hypoxia remains a major contributor to stillbirth, hypoxic ischemic encephalopathy and cerebral palsy. For parents and families, the psychosocial and financial impact ($1.5 billion in Australia) of these complications are profound and long-lasting. The majority of these catastrophic events occur despite a lack of obvious risk factors. Objectives: To explore the relationship between feto-placental and feto-maternal Doppler ultrasound variables and maternal serum placental growth factor (PlGF) concentration with adverse perinatal outcomes (caesarean for intrapartum fetal compromise, CS-IFC; operative delivery of any kind for intrapartum fetal compromise, Op-IFC; or composite neonatal outcome, CNO) in low risk pregnancies from 36 weeks' gestation. Additionally, to determine the screening performance of these variables. Methods: A prospective, observational, panel study of low risk women was conducted at Mater Mothers' Hospital, Brisbane. Women were eligible to participate if they were normotensive with an appropriately grown singleton fetus, uncomplicated pregnancy and anticipating a vaginal delivery beyond 36 weeks' gestation. Women underwent fortnightly assessment of various feto-placental and feto-maternal Doppler parameters, estimated fetal weight and maternal PlGF quantification. Maternal characteristics, ultrasound and PlGF data, intrapartum and neonatal outcomes were recorded. For each assessment and for the last assessment preceding delivery, ultrasound and PlGF variables were assessed for their distribution and association with outcomes. Additionally, the rate of change in the individual variables was tested for association with outcomes for the different gestation intervals at assessment. Finally, the screening performance of ultrasound and PlGF parameters were tested in isolation and combination for raw and gestation-adjusted (regression and centiles) variables. Results: From May 2014 to September 2016, 483 women participated in the study, with exclusions predominantly for missing data and planned cesarean delivery. For the Doppler parameters, the following associations were demonstrated: the umbilical artery pulsatility index (PI) was higher at 40 weeks' gestation for babies in the adverse Op-IFC outcome group; the middle cerebral artery PI was lower in the adverse outcome groups for CS-IFC (40 weeks' gestation), Op-IFC (36, 38, 40 weeks' gestation and last assessment) and CNO (last assessment) groups; the cerebroplacental ratio was lower in the adverse outcome groups for CS-IFC (40 weeks' gestation and last assessment), Op-IFC (38 and 40 weeks' gestation and last assessment) and CNO (40 weeks' gestation and last assessment); weight-adjusted umbilical venous flow rate was lower in the adverse outcomes groups for CS-IFC iv (38 weeks' gestation), Op-IFC (38 weeks' gestation and last assessment) and CNO (last assessment); the uterine artery PI was higher in the ...

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Cerebral artery blood flow velocity waveforms in normal and small for dates fetuses.

Abstract: Middle cerebral artery (MCA) blood flow velocity waveforms were recorded by a pulsed Doppler system in normal and small for dates (SFD)

Cited by 6 publications

References 8 publications

Blood Flow Velocity Waveforms of the Fetal Middle Cerebral Artery in Pregnancies Complicated by Diabetes Mellitus.

Blood Flow Velocity Waveforms of the Fetal Middle Cerebral Artery in Pregnancies Complicated by Diabetes Mellitus.

Study of Maternal and Fetal Doppler Velocimetry, Histopathology of Placental Bed in Diabetic Pregnancy and Its Correlation to Fetal Outcome

Prediction of fetal distress

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