Middle cerebral artery Doppler indices better predictor for fetal outcome in IUGR

Behind KD Care Hospital, 314, Saket Nagar, Indore, 452 001 M.P, India
Journal of Obstetrics and Gynecology of India 04/2011; 61(2):166-171. DOI: 10.1007/s13224-011-0018-7


To compare the role of middle cerebral artery and umbilical artery Doppler pulsatility indices in predicting the fetal outcome in intrauterine growth restriction.
The prospective study was conducted on 121 subjects. They were divided into two groups. The study group (n=71) consists of high risk group of pregnant women with growth restricted fetuses. The control group (n=50) consists of pregnant women with healthy fetuses. Both the groups were evaluated by middle cerebral artery and umbilical artery velocimetry between 28 and 41 weeks of pregnancy.
Mothers with abnormal velocimetry had more number of cesarean sections to prevent fetal distress than those with normal velocimetry. The subjects with high risk factors had more number of abnormal waveforms than those without high risk factors. The predictive value of Doppler P.I for detecting abnormal fetal outcome was 94% in middle cerebral artery as against 83% for umbilical artery. The sensitivity was 71% for middle cerebral artery versus 44% for umbilical artery.
Growth restricted fetuses with normal flow velocimetry are at a lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower as compared to that of neonates with normal velocimetry. Thus middle cerebral artery doppler indices were a better predictor for fetal outcome in IUGR when compared with umbilical artery in terms of sensitivity and predictive value.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Scaling, for enhanced performance and cost reduction reasons, has pushed existing CMOS materials much closer to their intrinsic reliability limits. Future robust designs will require a strong team effort whereby the design engineer must clearly understand the process variability and its impact on reliability. This strong team effort, between design and process, will become critically important as the industry is seeking to replace the very materials that has made the industry so successful: Si substrates, SiO<sub>2</sub> gate-dielectric, Al-based metallization and SiO<sub>2</sub> interconnect-dielectrics
    No preview · Conference Paper · Feb 2001
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives: Fetal growth restriction is defined as a pathologic decrease in the rate of fetal growth. The most frequent etiology for late onset fetal growth restriction is uteroplacental dysfunction which is due to inadequate supply of nutrients and oxygen to support normal aerobic growth of the fetus. However, for symmetrical IUGR, fetal chromosomal anomalies, structural anomalies and fetal infections should be carefully excluded. Consequent to the uteroplacental vascular maladaptation of endovascular trophoblastic invasion, there is increased vascular resistance and decreased blood flow to the placenta in the choriodecidual compartment. Conclusions: This under perfusion of the placenta causes villous damage; that is, total tertiary villous capillary bed is reduced leading to increased placental resistance. These changes can be diagnosed by Doppler and characteristic changes are seen in the uterine, umbilical, middle cerebral arteries and ductus venosus vessels. In severe cases, delivery of the fetus with optimum intrapartum surveillance, or caesarean section, is essential.
    Preview · Article · Oct 2011
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background and Objectives Intrauterine growth restriction is associated with increased perinatal mortality and morbidity, possibly extending also in adult life, as compared to fetuses and newborns presenting characteristics of normal growth. The present study had been planned to measure the pulsatility index (PI) and resistive index of the middle cerebral artery with pulsatility and resistive index of the umbilical artery in predicting fetal growth restriction. Materials and Methods A total of 60 pregnant women with a clinical history and grayscale-screened patients were taken for Doppler analysis, and a final comparison of accuracy of Doppler indices was done with perinatal outcome. Statistical Analysis The statistical analysis was done using the Statistical Package for Social Sciences version 15.0 statistical analysis software. The values were represented in number (%) and mean ± SD. Observation and Results The umbilical artery PI had maximum sensitivity at the third visit (32–37 weeks) and maximum specificity also at the third visit (32–37 weeks). The umbilical artery resistive index had maximum sensitivity at the second visit (28–32 weeks) and maximum specificity at the third visit (32–37 weeks). The MCA PI had an overall diagnostic accuracy of 52.8 %. Conclusion The PI of the umbilical artery was more sensitive than the PI of the middle cerebral artery. Umbilical artery PI has the maximum overall diagnostic accuracy of 75 %.
    Full-text · Article · Aug 2013 · Journal of Obstetrics and Gynecology of India
Show more