title: The clinical significance of Doppler findings in fetal middle cerebral artery during labor.
abstract: 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.
authors.affiliation: 2nd Department of Obstetrics and Gynaecology, Areteion Hospital, 17 Didimotichou Str., Thrakomakedones, Athens 13676, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kassanos
authors.forename: Charalambos
authors.initials: C
authors.lastname: Siristatidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vitoratos
authors.forename: Emmanouel
authors.initials: E
authors.lastname: Salamalekis
authors.forename: George
authors.initials: G
authors.lastname: Creatsas
mesh_terms: 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
chemical_list: D010100:Oxygen