Cerebral and umbilical vascular resistance response to vibroacoustic stimulation in growth-restricted fetuses.
OBJECTIVE
To test the hypothesis that after vibroacoustic stimulation the ratio between cerebral vascular and umbilical vascular resistance in the growth-restricted fetus is different from that in the normal fetus.


METHODS
The pulsatility index (PI) of the middle cerebral artery and that of the umbilical artery (UA) were measured by pulsed Doppler velocimetry in 30 normal and 14 growth-restricted fetuses before and after vibroacoustic stimulation. The ratios of cerebral PI to UA PI and the changes in PI after vibroacoustic stimulation were calculated. Comparisons were made using the Wilcoxon rank-sum test or signed-rank test. The statistical power of the study was 80%.


RESULTS
Mean (+/- standard deviation) cerebral PI values before vibroacoustic stimulation (1.50 +/- 0.29) in normals and 1.29 +/- 0.26 in the fetal growth restriction [FGR] group) and UA PI values (1.00 +/- 0.18 in normals and 1.15 +/- 0.24 in the FGR group) were significantly different between groups (P < .04) and significantly decreased after vibroacoustic stimulation (P < .05). Although the cerebral to UA PI ratios (1.50 +/- 0.38 in normals and 1.13 +/- 0.33 in the FGR group) were significantly different between groups (P < .008), the values remained the same after vibroacoustic stimulation (P = .39 and .80, respectively). In all fetuses the fetal heart rate accelerated after vibroacoustic stimulation.


CONCLUSIONS
Cerebral vascular resistance was lower and umbilical vascular resistance higher in the growth-restricted fetuses than in normals. The vascular resistance response after vibroacoustic stimulation in the growth-restricted fetus was not significantly different from the response of the normal fetus, suggesting preservation of regulation of resistance.
Loy
G L
GL
Department of Obstetrics and Gynecology, University of Chicago, Illinois, USA.
Lin
C C
CC
Chien
E K
EK
Kim
J H
JH
Chiang
L M
LM
D000161:Acoustic Stimulation; D000222:Adaptation, Physiological; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000503:physiopathology*; D005260:Female; D005317:Fetal Growth Retardation / Q000503:physiopathology*; D006340:Heart Rate, Fetal; D006801:Humans; D017078:Laser-Doppler Flowmetry; D011247:Pregnancy; D011673:Pulsatile Flow; D018709:Statistics, Nonparametric; D014469:Umbilical Arteries / Q000503:physiopathology*; D014655:Vascular Resistance; D014732:Vibration