[Significance of middle cerebral artery doppler velocimetry based on behavioral states in intrauterine growth retarded fetuses--prediction of development of fetal distress].
Middle cerebral artery resistance indices (MCARI) based on fetal behavioral states were calculated in 60 normal and 20 intrauterine growth retarded (IUGR) fetuses between 33 and 40 weeks of gestational age. Fetal behavioral states were determined by recording fetal actocardiograms. The results obtained were as follows: 1. MCARI was significantly lower in the active phase than in the resting phase in normal fetuses. 2. Of the 20 IUGR fetuses, 9 subsequently developed fetal distress. Seven of 11 fetuses who did not develop fetal distress had abnormally low MCARI (less than M-2.0 SD) in the active phase. On the other hand, seven of the fetuses that subsequently developed fetal distress had abnormal MCARI not only in the active phase but also in the resting phase. The fetuses that did not develop fetal distress had different MCARIs in the two phase, but the fetuses that developed fetal distress exhibited no such difference. 3. The sensitivity and specificity in predicting the development of fetal distress in IUGR fetuses with abnormal MCARI in the resting phase were 77.8% and 81.8%, respectively. This study showed that in normal fetuses MCARI differs according to the behavioral state, and that resting phase MCARI is useful for predicting fetal distress in IUGR fetuses.
Kadowaki
K
K
Department of Obstetrics and Gynecology, Tottori University, Yonago, Japan.
D000328:Adult; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000196:embryology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D005316:Fetal Distress; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D011237:Predictive Value of Tests; D011247:Pregnancy; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal