Document Detail

Doppler velocimetry of different sections of the fetal middle cerebral artery in relation to perinatal outcome.
MedLine Citation:
PMID:  8880629     Owner:  NLM     Status:  MEDLINE    
To assess the standard curves of pulsatility index (PI) in different segments of middle cerebral artery (MCA): initial segment (MI) and subcortical segment (M2); to determine the variation of the flow velocity waveforms (FVW) of the M1 and M2 segments of MCA in presence of fetal distress and to establish the possible correlation between the two segments of MCA. 50 normal pregnancies from 25 weeks of gestation to term and 20 pregnancy with alteration of fetal growth rate were investigated with serial records of the FVW of the M1 and M2 segments of the MCA and of the umbilical artery (UA) with a colour Doppler system. Severe fetal distress was associated to cerebral-placental ratio below 1 (C/P < 1). The perinatal outcome was established on the basis: 1) abnormal intrapartum CTG, 2) emergency cesarean section, 3) Apgar score at 1st and 5th minute after birth and 4) birth eight centiles. In normal pregnancy P1 of M2 was always higher than that of M1: therefore M2/M2 resulted below 1, with a maximum peak near 32 weeks of gestation. In presence of moderate fetal distress only P1 of M2 was reduced (M1/M2 > 1). It exists a significant difference of PI in M1 and M2 segments of fetal MCA during gestation: thus MCA so it is important to identify the tract of fetal MCA when recording its FVW. Moreover we suppose that an initial "cerebral sparing" effect exists in order to protect the cortex by the initial hypoxic injury: this is shown by a M1/M2 > 1. The progression of fetal distress results in a greater haemodynamic modification, the so called "brain sparing" which is usually present when C/P < 1.
G Luzi; G Coata; G Caserta; E V Cosmi; G C Di Renzo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of perinatal medicine     Volume:  24     ISSN:  0300-5577     ISO Abbreviation:  J Perinat Med     Publication Date:  1996  
Date Detail:
Created Date:  1997-01-23     Completed Date:  1997-01-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0361031     Medline TA:  J Perinat Med     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  327-34     Citation Subset:  IM    
Institute of Gynecology and Obstetrics, University of Perugia, Italy.
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MeSH Terms
Apgar Score
Birth Weight
Cardiotocography / statistics & numerical data
Cerebral Arteries / embryology,  ultrasonography*
Cesarean Section / statistics & numerical data
Cohort Studies
Fetal Growth Retardation / physiopathology
Gestational Age
Laser-Doppler Flowmetry*
Pregnancy Outcome
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Pulsatile Flow / physiology*
Reference Values

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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