title: Doppler study of the fetal vertebral and middle cerebral arteries in fetuses with normal and increased umbilical artery resistance indices.
abstract: OBJECTIVE
  To compare the brain sparing mechanism of the fetal vertebral artery (VA), with the one of the middle cerebral artery (MCA) in fetuses with increased umbilical artery (UA) Doppler impedance.
  
  
  METHODS
  We retrospectively studied 1084 Doppler examinations of the VA, MCA and UA performed in 1084 fetuses between 19 and 41 week of gestation. These were divided into 3 groups according to the UA resistance index (UA RI): group 1: UA RI < 95(th) percentile (N = 965), group 2: UA RI > 95(th) percentile (N = 111) and group 3: absent UA diastolic flow (N = 8). Afterwards, values were converted into multiples of the median (MoM), and means and standard deviations were calculated. Finally, Kruskal-Wallis tests and box and whiskers charts were applied to evaluate differences.
  
  
  RESULTS
  For both, the VA RI and MCA RI, no differences were seen among the groups of fetuses who maintained diastolic flow in the UA. However, the VA RI and MCA RI were lower when the UA diastolic flow was absent.
  
  
  CONCLUSIONS
  The VA and MCA work in unison, decreasing impedances only when UA flow is severely affected.
authors.affiliation: Servicio de Obstetricia y Ginecología, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Morales Roselló
authors.forename: David
authors.initials: D
authors.lastname: Hervás Marín
authors.forename: Alfredo
authors.initials: A
authors.lastname: Perales Marín
authors.forename: Sara
authors.initials: S
authors.lastname: López Fraile
mesh_terms: D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005865:Gestational Age; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D011247:Pregnancy; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014655:Vascular Resistance; D014711:Vertebral Artery / Q000000981:diagnostic imaging* / Q000502:physiology