Determining the Correlation of Fetal Middle Cerebral Artery Doppler Indices in IUGR Pregnancies | Chapter 1 | Recent Developments in Medicine and Medical Research Vol. 9

 Background and Goals: Doppler velocimetry studies of placental and foetal circulation can provide critical information regarding foetal health, allowing for better foetal outcomes. The goal of this study was to see if the foetal middle cerebral artery blood velocity waveforms, the Systolic/Diastolic ratio (S/D), the Pulsatility Index (PI), and the Resistance Index (RI) could be used to predict perinatal outcome in IUGR pregnancies in the second and third trimesters. Methods: During the second and third trimesters, 50 cases of IUGR were studied in the study group. They had ultrasonography biometry first, then Doppler sonography of the middle cerebral artery.

The S/D ratio, PI, and RI in the middle cerebral artery in both the control and study groups decreased during the second to third trimester.

The research group's values were lower than the control group's. As a result of this study, it is expected that: a) Lower PI values were associated with foetal hypoxia. b) The lower figures are due to hypoxia-induced vasodilation, which allows more blood to reach the brain and protects it from hypoxia's damaging effects. As a result, there is no risk to the brain.

Doppler imaging is a noninvasive tool for evaluating the fetomaternal and uteroplacental circulations. The middle cerebral artery's indications have been proven to be beneficial in predicting the fate of IUGR pregnancies.

Author(S) Details

Padmaja R. Desai
Department of Physiology, D Y Patil Medical College, Kolhapur, M.S., India, 416006, 4 Director, Radiologist, Marvel Diagnostic Center, Kolhapur, M.S. India.

Rupesh P. Dahilkar
Department of Physiology, D Y Patil Medical College, Kolhapur, M.S., India, 416006, 4 Director, Radiologist, Marvel Diagnostic Center, Kolhapur, M.S. India.

S. M. Tiwale
Department of Physiology, D Y Patil Medical College, Kolhapur, M.S., India, 416006, 4 Director, Radiologist, Marvel Diagnostic Center, Kolhapur, M.S. India.

Rajey M. Desai
Department of Physiology, D Y Patil Medical College, Kolhapur, M.S., India, 416006, 4 Director, Radiologist, Marvel Diagnostic Center, Kolhapur, M.S. India.

Arati A. Joshi
Department of Physiology, D Y Patil Medical College, Kolhapur, M.S., India, 416006, 4 Director, Radiologist, Marvel Diagnostic Center, Kolhapur, M.S. India.

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Fetal Growth Restriction and Doppler Waveform: Current Research | Chapter 1 | Research Trends and Challenges in Medical Science Vol. 3

Fetal growth restriction (FGR) is defined as the estimated fetal weight less than the 10th percentile for that gestational age on ultrasound study. There is no proven cure; management is reliant on a structured antenatal surveillance programme. Recent advances in ultrasound and Doppler have elucidated several mechanisms of growth restriction. Prediction of intrauterine hypoxia and acidemia can be done by Doppler study of fetal cardiovascular system. In this chapter it is discussed how to analyse the uteroplacental and fetoplacental blood flow using Doppler ultrasound in growth-restricted fetuses with reference to flow velocity and waveform indices. The Doppler ultrasound examination of the fetal cardiovascular system is mostly performed after 28 weeks of gestation in pregnancies with fetal growth restriction.  In the present chapter we highlight that preeclampsia and maternal anaemia have beed found to be the most important cause of fetal growth restriction. Abnormal Doppler indices in umbilical and middles cerebral artery statistically correlate with lower birth weights, higher rate of caesarean delivery, oligohydramnios, low Apgar scores, perinatal death and higher admission to neonatal intensive care unit. Reduced end diastolic flow or complete absence of it in the umbilical artery is associated with poor perinatal outcome. Cerebroplacental Ratio (pulsatility index of middle cerebral artery/pulsatility index of umbilical artery) less than 1 is a very sensitive and specific sign of fetal compromise. Conclusion: Abnormal Doppler waveforms within the umbilical and middle cerebral arteries are indicative of redistribution of cerebral blood flow in fetal hypoxia. If there is reduced or low blood flow during diastole in umbilical arteries, the fetal perfusion becomes intermittent and fetal hypoxia develops. The blood flow redistributes to vital organs like brain and kidneys and the pulsatility index of middle cerebral artery falls in the fetus. The plausible explanation of it is, sympathetic activation in a hypoxemic fetus leading to increased cerebral perfusion. The ductus venosus flow gets reduced and reversed along with continued hypoxia.

Author(s) Details

Nidhi Sharma 
Department of Obstetrics and Gynaecology, Saveetha Medical College Saveetha University, Chennai-602105, India.

Benjamin M. Sagayaraj
Department of Pediatrics, Saveetha Medical College, Saveetha University, Chennai-602105, India.

 Jayavelan Ramkumar 
Department of Cardiothoracic Vascular Surgery, Sri Ramachandra Medical College, Sri Ramachandra University, Chennai, India.

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