The clinical significance of antenatal pathological Doppler findings in the fetal middle cerebral artery in cases with peripheral reduced diastolic doppler flow but no absence of end-diastolic flow in the umbilical artery or fetal aorta.
OBJECTIVE
The effects of antepartum pathological Doppler findings in the fetal middle cerebral artery in cases with simultaneously peripheral reduced diastolic Doppler flow on perinatal outcome and the odds ratio of perinatal risks were studied.


METHODS
214 patients were examined by color Doppler ultrasound in relationship to complications in gestation and labor and fetal outcome. One thousand and seventy Doppler flow measurements of the middle cerebral artery, the umbilical artery and the fetal aorta between 28 and 40 weeks of gestation were performed. Sensitivity and odds ratio of synchronous cerebral pathological and peripheral pathological Doppler blood flow with regard to the prediction of intrauterine growth retardation, rate of cesarean section, preterm delivery and newborn depression was calculated. In all Doppler measurements there were no cases with absence of end-diastolic flow.


RESULTS
Preterm delivery rate and intrauterine growth retardation rate were significantly higher in cases of synchronous cerebral pathological and peripheral pathological Doppler blood flow as in cases of isolated reduced peripheral blood flow (p<0.001; odds ratio 13.2 and 16.6).


CONCLUSIONS
Pregnancies with no absence of end-diastolic flow in the fetal aorta or umbilical artery, but with reduced diastolic flow in these vessels and simultaneous pathological Doppler findings in the fetal middle cerebral artery are high risk pregnancies, above all in respect to intrauterine growth retardation, preterm delivery and newborn depression. Surveillance of pregnant women should be performed in a perinatal centre.
Meyberg
R
R
Department of Obstetrics and Gynecology of the University of the Saarland, Homburg/Saar, Germany.
Tossounidis
I
I
Ertan
A K
AK
Friedrich
M
M
Schmidt
W
W
D001011:Aorta / Q000196:embryology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000196:embryology*; D005260:Female; D005316:Fetal Distress / Q000000981:diagnostic imaging*; D006801:Humans; D011247:Pregnancy; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000503:physiopathology