Middle cerebral artery blood flow velocimetry among healthy fetuses with a single umbilical artery.
OBJECTIVE
A single umbilical artery (SUA) is an independent risk factor for perinatal morbidity and mortality in healthy fetuses. The aims of the study were (1) to determine middle cerebral artery (MCA) blood flow velocimetric values among fetuses without structural or chromosomal anomalies with an SUA and to compare them with nomograms of patients with a 3-vessel cord and (2) to measure the pulsatility index (PI) of the umbilical artery among these patients.


METHODS
The PI values of the MCA and umbilical arteries were determined prospectively among 98 healthy fetuses with an SUA. The PI values were compared with nomograms of patients with a 3-vessel umbilical cord. For the MCA, peak systolic velocity (PSV) was also measured. Patients carrying fetuses with intrauterine growth restriction or congenital anomalies were excluded from the study. Middle cerebral artery PI values below the fifth percentile and PSV values above the 95th percentile adjusted for gestational age were considered abnormal.


RESULTS
Gestational age ranged between 22 and 37.9 weeks (median, 30.3 weeks). After adjusting for gestational age, no alterations in the MCA PI and umbilical PI were found in comparison with the normal range for a 3-vessel cord known in the literature. Middle cerebral artery PSV values were also within the normal range for gestational age in all patients.


CONCLUSIONS
The MCA PI and PSV values among healthy fetuses with an isolated SUA were similar to nomograms for fetuses with a 3-vessel umbilical cord. Therefore, abnormal MCA PI and PSV values among fetuses with an SUA should be treated the same as in patients with a 3-vessel umbilical cord.
Hershkovitz
Reli
R
Ultrasound Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, 84101 Beer-Sheva, Israel. ralikah@bgumail.bgu.ac.il
Sheiner
Eyal
E
Mazor
Moshe
M
D000328:Adult; D001783:Blood Flow Velocity; D005260:Female; D005865:Gestational Age; D006801:Humans; D020768:Middle Cerebral Artery / Q000196:embryology* / Q000502:physiology*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000502:physiology*; D014470:Umbilical Cord / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014599:Uterus / Q000098:blood supply