Middle cerebral artery Doppler in fetuses with transposition of the great arteries.
OBJECTIVE
A previous anthropometric study has shown that neonates with transposition of the great arteries have a smaller head circumference and intracranial volume, which may be related to a lower oxygen content of blood delivered to the head and upper extremities. The aim of this study was to compare Doppler blood flow velocity waveforms in fetuses with transposition of the great arteries with those in healthy fetuses.


METHODS
Doppler blood flow velocimetry was performed in the middle cerebral artery, the umbilical artery, the aorta and the ductus venosus in a consecutive series of 23 fetuses with transposition of the great arteries between 36 and 38 weeks' gestation. The control group consisted of 40 healthy fetuses matched for gestational age.


RESULTS
There was no significant difference in pulsatility indices in the umbilical artery, the aorta and the ductus venosus between fetuses with transposition of the great arteries and controls. The median middle cerebral artery pulsatility index in the group with transposition of the great arteries was 1.37 (range, 1.10-2.02) and was significantly lower than that in the control group (median, 1.68; range, 1.46-2.04) (P < 0.001, Mann-Whitney test).


CONCLUSIONS
The lower pulsatility indices observed in the middle cerebral artery of fetuses with transposition of the great arteries may reflect a trend towards cerebral vasodilation. This phenomenon could be an indicator of hypoxemia and/or hypercapnia restricted to areas perfused by the preisthmus aorta and be related to the characteristics of the circulation in fetuses with transposition of the great arteries.
Jouannic
J-M
JM
Maternité, Hôpital Necker-Enfants-Malades, AP-HP-Université Paris V, Paris. jean-marie.jouannic@nck.ap-hop-paris.fr
Benachi
A
A
Bonnet
D
D
Fermont
L
L
Le Bidois
J
J
Dumez
Y
Y
Dommergues
M
M
D001783:Blood Flow Velocity; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies; D011673:Pulsatile Flow; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016216:Ultrasonography, Prenatal; D014664:Vasodilation