Document Detail

Systematic review and meta-analysis of middle cerebral artery Doppler to predict perinatal wellbeing.
MedLine Citation:
PMID:  22901972     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Identification of the fetus at risk of compromise is crucial to judicious allocation of monitoring resources and use of preventative treatment with the prospect of improving perinatal outcome. The accuracy of middle cerebral artery (MCA) Doppler for prediction of the fetus at risk of compromise of wellbeing is not known. The objective of this systematic review with bivariate meta-analysis was to evaluate the accuracy of middle cerebral artery Doppler for prediction of compromise of fetal/neonatal wellbeing.
STUDY DESIGN: Systematic review and bivariate meta-analysis with searches of Medline, Embase, Cochrane library, Medion (inception to October 2011), hand searching of journal and reference lists, contact with experts. Two reviewers independently selected articles in which the results of middle cerebral artery Doppler were associated with the occurrence of compromise of fetal/neonatal wellbeing. There were no language restrictions applied.
RESULTS: Thirty-five studies, testing 4025 fetuses, met the selection criteria. Data were extracted on study characteristics, quality and results to construct 2×2 tables. Likelihood ratios for positive and negative test results, sensitivity, specificity and their 95% confidence intervals were generated for the different indices and thresholds. Meta-analysis showed low predictive accuracy. For prediction of adverse perinatal outcome and perinatal mortality the results were positive likelihood ratios 2.77 (1.93, 3.96) and 1.36 (1.10, 1.67) and negative likelihood ratios 0.58 (0.48, 0.69) and 0.51 (0.29, 0.89) respectively.
CONCLUSION: Abnormal middle cerebral artery Doppler showed limited predictive accuracy for compromise of fetal/neonatal wellbeing. High quality primary research or individual patient data meta-analysis looking at this test in combination with other tests is required.
R K Morris; R Say; S C Robson; J Kleijnen; K S Khan
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2012-08-15
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  165     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-03     Completed Date:  2013-05-16     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  141-55     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Fetal Growth Retardation / diagnosis
Infant, Newborn
Infant, Small for Gestational Age
Middle Cerebral Artery / ultrasonography*
Predictive Value of Tests
Ultrasonography, Prenatal*
Grant Support
G0700526//Medical Research Council

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

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