[Prognostic Doppler ultrasound examination of fetal arteries blood flow].
Early detection of fetal risk is one of the main issues in today obstetrics. Ultrasound diagnostics plays a significant role, as the introduction of Doppler imaging method in the evaluation of blood flow has enabled non-invasive assessment of uteroplacental circulation. Therefore, we have analysed foetal three arteries: umbilical artery, middle cerebral artery and renal artery after determining the normal range for the analysed parameters.


OBJECTIVE
1. Comparison of the obtained blood flow indices (S/D, RI, PI) in the umbilical artery, middle cerebral artery and renal artery of foetuses from normal and complicated full-term pregnancies. 2. Determination of indices: umbilical-cerebral and renal-cerebral in normal and pathological pregnancy. 3. Evaluation of feasibility of the analysed flow parameters for the detection of intrauterine foetal hypoxia.


METHODS
We have examined 151 women, who were divided into control group--101 pregnant women with normal pregnancy and study group--50 pregnant women with complicated pregnancy. All pregnant women underwent ultrasound examination using the Hitachi EUB 515 C (Japan) scanner with 3.5 MHz convex probe, connected to the colour pulsed Doppler. The study consisted of the biometric measurements and evaluation of the spectrum of blood flow in the umbilical artery, middle cerebral artery and renal artery. We have determined following indices: a) systolic-diastolic ratio S/D, resistance index RI, pulsatility index PI, b) umbilical-cerebral ratio P/M. (PI ua/PI mca), renal--cerebral ratio N/M (PI ra/PI mca).


RESULTS
Statistically significant difference was found between the study and control groups for all the flow indices assessed (S/D, RI, PI) for the middle cerebral artery, for the indices P/M and N/M. (p < 0.001) and pulsatility index in the renal artery (p < 0.01). Similar, although slightly smaller difference (p < 0.05) was seen for the values of flow parameters in the umbilical artery.


CONCLUSIONS
1) Evaluation of blood flow in the middle cerebral artery, and in particular pulsatility index PI, reflects the risk to foetus. Umbilical-cerebral index and renal-cerebral index demonstrate the mechanisms of circulation centralization in case of fetal distress. For the umbilical-cerebral index, the cut-off value is 1.0 and for the renal-cerebral index it is 2.5, 2) Evaluation of the blood flow in foetal vessels is a significant element of prenatal diagnostics. Due to its low sensitivity, it should be compared with the results of other biophysical tests, to achieve complex evaluation of the condition of the foetus.
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging* / Q000196:embryology; D001783:Blood Flow Velocity; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D005312:Fetal Blood / Q000000981:diagnostic imaging*; D005311:Fetal Hypoxia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011247:Pregnancy / Q000502:physiology*; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D012077:Renal Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods*; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging
Wartość prognostyczna badania dopplerowskiego przepływu krwi w tetnicach płodu.