The clinical significance of Doppler findings in fetal middle cerebral artery during labor.
OBJECTIVE
(1) To investigate fetal intracranial circulation, relative to peripheral blood flow, during labor with abnormal cardiotocographic (CTG) patterns, using three non-invasive methods. (2) To determine the utility of monitoring middle cerebral artery (MCA) Doppler during labor.


METHODS
Fetuses were assessed using simultaneous CTG, pulse oximetry, and Doppler ultrasonography of both the MCA and umbilical artery (UA) to measure the pulsatility index (PI), resistance index (RI), and flow velocity integral (FVI).


METHODS
During labor 20 term fetuses with abnormal CTG patterns and oxygen saturation values >30%, and 24 term fetuses with abnormal CTG patterns and oxygen saturation values <30% were studied, and peripartum outcomes were compared. The groups were comparable with regard to maternal age and parity. Results were evaluated using the Student's t-test and Fisher exact test.


RESULTS
MCA Doppler showed significantly lower PI and RI, and higher FVI in the presence of reduced oxygen saturation. Differences in fetal outcomes between the two groups correlated with MCA Doppler findings.


CONCLUSIONS
In experienced hands, Doppler screening of fetal middle cerebral artery waveforms during labor can be useful in the evaluation of intrapartum hypoxia in complicated pregnancies.
Kassanos
Dimitrios
D
2nd Department of Obstetrics and Gynaecology, Areteion Hospital, 17 Didimotichou Str., Thrakomakedones, Athens 13676, Greece.
Siristatidis
Charalambos
C
Vitoratos
Nikolaos
N
Salamalekis
Emmanouel
E
Creatsas
George
G
D001783:Blood Flow Velocity; D015148:Cardiotocography; D005260:Female; D005333:Fetus / Q000098:blood supply; D006801:Humans; D007743:Labor, Obstetric; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000196:embryology*; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011673:Pulsatile Flow; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance
D010100:Oxygen