Cerebral Blood Flow Velocity Waveforms: Clinical Application

Detti, Laura; Segata, M.; Mari, Giancarlo

doi:10.1007/3-540-28903-8_14

Cited by 2 publications

(3 citation statements)

References 63 publications

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“…This phenomenon, known as the brain-sparing effect, occurs in the setting of hemorrhage, hypoxemia and decreased uterine blood flow, and is likely an autoregulatory mechanism that serves to protect the brain and the other vital organs (heart and adrenal glands). [1][2][3][4][5][6][7][8] The autoregulatory capacity of the fetus may further depend on its gestational age, the level of arterial oxygenation and the cerebral perfusion pressure. [9][10][11][12][13] At the present time, there is paucity of data on cerebral autoregulation in the human fetus because of the invasive nature of hemodynamic monitoring and the ethical issues involved with manipulation of the intrauterine environment.…”

Section: Introductionmentioning

confidence: 99%

Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

et al. 2010

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Objective: The objective of this study was to compare alterations in the middle cerebral artery (MCA) pulsatility index (PI) and mean velocity (V mean ) after laser surgery for twin-twin transfusion syndrome (TTTS).Study Design: MCA Doppler studies were conducted 1 day before and after laser surgery for TTTS. The pre-and postoperative mean (standard deviation) of the MCA PI and V mean z-scores of the recipient and donor fetuses were calculated and compared. Data were analyzed using paired testing and multivariable linear regression models.Results: A total of 103 patients met the study criteria. Recipients' MCA PI increased from À1.29 (1.20) preoperatively to 0.14 (1.52) postoperatively (P<0.0001), whereas the donors' PI did not change significantly (À0.31 (1.67) to À0.67 (1.29); P ¼ 0.12). There was no significant difference between preoperative and postoperative MCA V mean in donors (0.39 (0.83) and 0.38 (0.93), respectively; P ¼ 0.5048) or recipients (0.60 (0.74) and 0.63 (0.90), respectively; P ¼ 0.5324).Conclusions: Despite the changes in the MCA PI after laser surgery for TTTS, the MCA V mean remained constant. These findings may suggest some autoregulatory capacity in the cerebral vessels of the mid-trimester fetus.

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Section: Introductionmentioning

confidence: 99%

Fetal middle cerebral artery Doppler fluctuations after laser surgery for twin–twin transfusion syndrome

et al. 2010

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“… 1 Mechanistically, likely progressive decreases in fetal hemoglobin cause decreased blood viscosity resulting in elevated MCA PSV. 4 Severe fetal growth restriction is not known to have an impact on MCA PSV. Doppler evaluation of the MCA has further utility in detecting brain sparing in growth‐restricted fetuses, which causes increased end‐diastolic velocity and decreased MCA pulsatility index.…”

Section: Discussionmentioning

confidence: 99%

“…In 2000, Mari and associates illustrated that an increased MCA PSV had 100% sensitivity in predicting moderate/severe fetal anemia 1 . Mechanistically, likely progressive decreases in fetal hemoglobin cause decreased blood viscosity resulting in elevated MCA PSV 4 . Severe fetal growth restriction is not known to have an impact on MCA PSV.…”

Section: Discussionmentioning

confidence: 99%