Exploration of the fetal cerebral blood flow by duplex doppler—linear array system in normal and pathological pregnancies

Arbeille, P.; Roncin, A.; Berson, M.; Patat, F.; Pourcelot, L.

doi:10.1016/0301-5629(87)90166-9

Cited by 138 publications

(87 citation statements)

References 18 publications

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“…It means that if the Doppler is normal, in an IUGR case, the possibility of an abnormal perinatal outcome is very rare. [12][13][14] The normal Doppler result has more importance than an abnormal Doppler result. The explanation for these observations is probably that fetal growth retardation can be either due to low intrinsic growth potential or due to defective placental nutritive and circulatory functions, of which Doppler can investigate only the circulatory components.…”

Section: Discussionmentioning

confidence: 99%

Role of obstetric Doppler in prediction of adverse perinatal outcome in intrauterine growth retardation

Chirtrarasan

Kanagarameswarakumaran

2017

Int J Adv Med

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Background: Objective of current study was to determine and compare accuracy of various Doppler parameters for perinatal outcome. Umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) for predicting adverse perinatal outcome in patients of intrauterine growth retardation.Methods: 200 singleton pregnancies between 34 to 36 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery and ductus venosus. Patients kept under surveillance till confinement. According to increasing severity of Doppler indices categorized the cases into six grades from grade 0 to grade 5.Results: Out of 200 cases, 169 were live born and 24 were neonatal death. There were 5 cases of intrauterine death of foetuses and 2 were still born. Out of the live born 32 had increased perinatal morbidity like poor APGAR score, development of necrotizing enterocolitis, hypoxic ischemic encephalopathy, meconium aspiration syndrome, hyperbilirubinemia, and prolonged admission in neonatal care unit for reasons like sepsis / birth asphyxia.Conclusions: Absent end diastolic flow (EDF) / reversal in umbilical artery had high positive predictive value in predicting adverse foetal outcome. Ductus venosus changes seem to be an ominous sign of a severely compromised foetus with poor perinatal outcome. Doppler investigation of the MCA, UA and DV plays an important role in monitoring the compromised foetuses and helps to determine the optimal time of delivery.

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Section: Discussionmentioning

confidence: 99%

Role of obstetric Doppler in prediction of adverse perinatal outcome in intrauterine growth retardation

Chirtrarasan

Kanagarameswarakumaran

2017

Int J Adv Med

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“…The PEEP was stable for at least 5 minutes before the examination was completed. We measured each patient's cerebral perfusion, pulsatility index (PI = (PSV -EDV)/ TAV max ), and resistance index (RI = (PSV -EDV)/TAV max ), which serve as indirect signs of intracranial compliance and pressure [17][18][19]. In each patient, the right and left middle cerebral arteries (MCAs) were identified at an insonation of 52-58 mm.…”

Section: Inclusion Criteriamentioning

confidence: 99%

Influence of Positive End-Expiratory Pressure Ventilation on Cerebral Perfusion and Cardiac Hemodynamics

Backhaus¹,

Torka²,

Ertl³

et al. 2017

J Depress Anxiety

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“…[5,6] This compensatory adjustment on which the brain sparing effect is based is associated with a rise in diastolic velocities in Doppler cerebral artery waveforms. [7] This rise is considered a manifestation of cerebral vasodilatation, causing a decrease in Doppler indices such as the pulsatility index. [8,9] At cordocentesis, a significant correlation has been observed between hypoxemia in fetuses with IUGR and abnormal Middle Cerebral Artery (MCA) Pulsatility Index (PI).…”

Section: Introductionmentioning

confidence: 99%

Optimizing Perinatal Outcome in High Risk Pregnancies Using Doppler Velocimetry

Savithri¹,

Pallavi²,

Varadarajan³

et al. 2015

jemds

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BACKGROUNDHigh risk pregnancies poses a threat for fetoplacental vascular supply and are a risk for fetal growth retardation. Umbilical artery Doppler velocimetry is an important test among the invasive tests used for evaluating the fetal well-being. This study was taken to detect any abnormalities in fetoplacental unit and fetal circulation in high risk pregnancies, to identify the hypoxemic fetus and time the delivery before the occurrence of academia and to compare the perinatal outcome with doppler indices. STUDY DESIGN AND RESULTSThirty (30) patients with gestational age at or beyond 32 weeks of gestation who belong to high-risk pregnancies were included in the study and were subjected to clinical examination, biochemical tests, ultrasound and colour Doppler study. They were serially followed up with ultrasound and color Doppler at 34 and 36 weeks respectively. Findings of USG and Doppler studies were correlated with the perinatal outcomes. The uterine artery, umbilical artery and the Middle Cerebral Artery (MCA) Doppler indices for the corresponding gestational age were compared with the reference values. The middle cerebral artery Doppler index was considered abnormal, if the value was below the 5th percentile of previously published values for gestational age. A single cut off value (1.08) was used for Cerebroplacental Ratio (MCA PI/UA PI), above which the cerebro-placental ratio was considered normal and below which it was considered abnormal. CONCLUSIONSThe degree of abnormality in Doppler indicates the degree of fetal compromise. Absent End Diastolic Flow (AEDF) represents the extreme form of altered velocity in the umbilical arteries and it represents the fetus at highest risk of hypoxia. Reverse End Diastolic Flow (REDF) is an ominous sign indicating that the vascular resistance has reached a point where the blood flow is reversed during diastole indicating acidotic fetus. The foetuses with abnormal wave forms suffer from chronic hypoxia and are usually growth retarded. They are at increased risk for hypoxia and acidemia. The present study shows that in the high-risk pregnancies, serial Doppler velocimetry helps the obstetrician to identify fetus at hypoxia and timely delivery preventing acidemia.

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Exploration of the fetal cerebral blood flow by duplex doppler—linear array system in normal and pathological pregnancies

Cited by 138 publications

References 18 publications

Role of obstetric Doppler in prediction of adverse perinatal outcome in intrauterine growth retardation

Role of obstetric Doppler in prediction of adverse perinatal outcome in intrauterine growth retardation

Influence of Positive End-Expiratory Pressure Ventilation on Cerebral Perfusion and Cardiac Hemodynamics

Optimizing Perinatal Outcome in High Risk Pregnancies Using Doppler Velocimetry

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