Ultrasound probe pressure but not maternal Valsalva maneuver alters Doppler parameters during fetal middle cerebral artery Doppler ultrasonography

Su, Yiming; Lv, Guorong; Chen, Xiaokang; Shaohui, Li; Lin, Hui-Tong

doi:10.1002/pd.2648

Cited by 10 publications

(10 citation statements)

References 23 publications

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“…Fetal behavioral states influence the fetal cerebral hemodynamic pattern, with a significant decrease in MCA‐PI during fetal activity, this decrease being more marked in the proximal portion of the MCA. Variations in amniotic fluid volume and increased probe pressure have also been found to alter MCA measurements; singletons with polyhydramnios have significantly lower MCA‐PI than do those with normal amniotic fluid. Rizzo et al ,.…”

Section: Discussionmentioning

confidence: 99%

Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation

Mulcahy

McAuliffe

Breathnach

et al. 2014

Ultrasound in Obstet & Gyne

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Section: Discussionmentioning

confidence: 99%

Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation

Mulcahy

McAuliffe

Breathnach

et al. 2014

Ultrasound in Obstet & Gyne

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“…Another possible explanation would be to assume the increase of MCA PI and RI as a consequence of increased fetal intracranial pressure when applying external pressure with the transducer. In case of increased intracranial pressure, vessel caliber is reduced, leading to high peripheral vascular resistance and explaining the increase in Doppler indices in the MCA [10,12].…”

Section: Discussionmentioning

confidence: 99%

“…A study performed on adults by Homburg et al has noted that in case of increased intracranial pressure, the MCA Doppler parameters are modified [9]. At the same time, it was shown that the effect of maternal Valsalva maneuver did not alter the parameter values [10].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Probe Pressure on the Maternal Abdominal Wall and the Effect on Fetal Middle Cerebral Artery Doppler Indices

et al. 2019

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Background and objectives: Doppler ultrasound of umbilical and fetal vessels is useful for monitoring fetal well-being, fetal anemia, intrauterine growth retardation, and other perinatal outcomes. The adverse perinatal outcome and circulatory changes can be reflected in fetal Doppler studies. The aim of this study was to evaluate the effect of increased pressure exerted on the maternal abdominal wall during routine ultrasound on the middle cerebral artery (MCA), resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV). Materials and Methods: A prospective study was conducted, in which we included 40 pregnant women between 24 + 0 and 41 + 3 gestational weeks (GW), with singleton pregnancies, without any associated pathologies, undergoing routine US examination. We recorded the flow velocity waveforms in the MCA, and we measured the RI, PI, PSV, and the applied pressure on to the maternal abdominal wall—needed for a proper evaluation of MCA. We then repeated the same measurements at two different higher pressure levels, at the same time having a proper image of the targeted vessel. Results: We found significant differences for the PI and RI levels with an increase in abdominal pressure (median PI 1.46, 1.58, and 1.92, respectively; median RI 0.74, 0.78, and 0.85, respectively; p < 0.05), for both PI and RI. At the same time, we found no significant differences for PSV in the studied group in relationship with increase in abdominal pressure (median PSV 39.56, 40.10, and 39.70, respectively; p > 0.05). Conclusions: The applied abdominal pressure by the examiner’s hand, during routine US scan in pregnancy, can modify the MCA parameters of blood flow resistance (PI and RI) when measured by Doppler US, thus influencing the diagnostic accuracy in a series of pregnancy associated pathologies, such as chronic fetal distress (CFD) or intrauterine growth restriction (IUGR).

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“…During examination, a sonographic probe should touch the body gently because strong pressure can significantly increase RI, PI, and Vsyst and decrease Ved in MCA. But the Valsalva maneuver by mother doesn't affect Doppler parameters of blood flow in MCA [423]. Regarding prognosis and child management, the role of Doppler parameters of cerebral circulation as a complementary measurement in prenatal screening in fetal ventriculomegaly remains questionable.…”

Section: The Presence Of Bilateral Asymmetric Ventriculomegaly Characmentioning

confidence: 99%

The Role of Transcranial Doppler Sonography in the Management of Pediatric Hydrocephalus

Kolarovszki¹

2019

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IV 5. Etiology of hydrocephalus 5.1 Congenital hydrocephalus 5.2 Acquired postnatal hydrocephalus 6. Pathophysiology of hydrocephalus 6.1 Pathophysiological mechanisms of onset and development of hydrocephalus 6.2 Pathologic changes in hydrocephalus 6.3 Vascular changes in hydrocephalus 6.4 Biochemical changes in hydrocephalus 6.5 Changes of cerebral metabolism in hydrocephalus 7. Clinical manifestations of pediatric hydrocephalus 8. Basic properties of ultrasound 9. Biological effects of ultrasound 9.1 Thermal effects 9.2 Cavitation 9.3 Other mechanic effects 10. Doppler sonography 10.1 The role of Doppler principle in ultrasonography 10.2 The Doppler systems with continuous wave (CW) 10.3 The pulsatility Doppler systems (the pulsed waves, PW) 10.4 The color flow Doppler tomography (CFD, real-time two-dimensional Doppler) 10.5 The technique of the color Doppler power mapping (color Doppler energy, CDE; color power angio, CPA; Doppler power mode; power mapping) 11. The transcranial color-coded Doppler ultrasonography 11.1 The transcranial color-coded Doppler ultrasonographic examination 12. The Doppler curve, measured and calculated parameters 12.1 The Doppler curve 12.2 Measured and assessed parameters of the Doppler curve 12.3 Development of Doppler parameters of cerebral circulation: physiological values 12.3.1 Neonates 12.3.2 Infancy V 12.4 The factors influencing the value of qualitative indices of the Doppler curve 12.4.1 The factors increasing the resistance index of cerebral arteries 12.4.2 Factors decreasing the resistance index of cerebral arteries 13. Morphology of the cerebral ventricles in pediatric hydrocephalus 14. Assessment of Doppler parameters of the cerebral arteries in children with hydrocephalus 15. Case reports 15.1 Assessment of intracranial dynamics in the preterm neonate with hydrocephalus before and after insertion of external ventricular drainage 15.2 Observation of intraindividual dynamics in the preterm neonate with asphyxia and development of progressive hydrocephalus regarding indication of drainage procedure 15.3 Impact of tachycardia on Doppler parameters of blood flow in ACA in the infant with active hydrocephalus 15.4 Assessment of intracranial dynamics of the infant with schizencephaly 15.5 Assessment of intracranial dynamics in the term neonate with congenital hydrocephalus, Arnold-Chiari malformation type II and lumbosacral myelomeningocele 15.6 Assessment of intracranial dynamics in the preterm neonate with posthemorrhagic hydrocephalus 15.7 Assessment of intracranial dynamics in the neonate with occipital encephalocele and congenital hydrocephalus 15.8 Assessment of intracranial dynamics in the term neonate with birth trauma, intracerebral hemorrhage and hemocephalus 15.9 Assessment of intracranial dynamics in the neonate with congenital hydrocephalus and VP shunt revision 15.10 Assessment of intracranial dynamics of congenital hydrocephalus in prenatal and postnatal period

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Ultrasound probe pressure but not maternal Valsalva maneuver alters Doppler parameters during fetal middle cerebral artery Doppler ultrasonography

Abstract: Fetal MCA Doppler assessment is affected by increased probe pressure but not by maternal VM. Thus, the application of the MCA Doppler sonography should be undertaken in the head of fetuses without any probe pressure and without maternal VM.

Cited by 10 publications

References 23 publications

Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation

Umbilical and fetal middle cerebral artery Doppler reference ranges in a twin population followed longitudinally from 24 to 38 weeks' gestation

Ultrasound Probe Pressure on the Maternal Abdominal Wall and the Effect on Fetal Middle Cerebral Artery Doppler Indices

The Role of Transcranial Doppler Sonography in the Management of Pediatric Hydrocephalus

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