title: Fetal pulmonary and cerebral artery Doppler velocumetry in normal and high risk pregnancy.
abstract: Studies on fetal lung/brain circulation by means of power Doppler technique have suggested a marked reduction in lung perfusion in high-risk pregnancies as a sign of circulation redistribution. The ratio between lung/brain perfusion might therefore give a new method to predict fetal circulation centralization.
  
  
  OBJECTIVE
  The aim of the present study was to obtain fetal lung and cerebral artery ratio in normal and high-risk pregnancies.
  
  
  METHODS
  Doppler samples from proximal right pulmonary artery blood velocities and middle cerebral artery (MCA) were recorded cross-sectionally in 228 normal singleton pregnancies at gestational age 22 to 40 weeks. MCA/right pulmonary artery pulsatility index (PI) ratio was calculated. Doppler samples from proximal right pulmonary artery and MCA were also recorded in 89 high-risk singleton pregnancies and the results related to perinatal outcome.
  
  
  RESULTS
  In the normal controls, right pulmonary artery PI remained stable until 30 weeks of gestation with slight increase thereafter until term. The MCA to right pulmonary artery PI ratio increased between 22 and 28 weeks of gestation with the rapid fall towards term. In the high-risk pregnancies group, right pulmonary artery PI showed no significant correlation to perinatal outcome, but signs of brain-sparing in the MCA were correlated to all adverse outcome parameters.
  
  
  CONCLUSIONS
  Velocimetry of the middle cerebral artery is better than velocimetry of right pulmonary artery in predicting adverse outcome of pregnancy The brain/lung PI ratio does not improve the prediction of adverse outcome of pregnancy.
authors: Division of Reproductive Endocrinology and Infertility, Department of Ob/Gyn & Women's Health, Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA.
authors: Andrzej
authors: A
authors: Breborowicz
authors: Department of Obstetrics and Gynecology, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.
authors: Mariusz
authors: M
authors: Dubiel
authors: Department of Obstetrics and Women Diseases, Poznań University School of Medical Sciences, Poznań, Poland.
authors: Marek
authors: M
authors: Pietryga
authors: Department of Perinatology and Gynecology, Poznań University School of Medical Sciences, Poznań, Poland.
authors: Grzegorz H
authors: GH
authors: Breborowicz
authors: Department of Obstetrics and Gynecology, Malmö University Hospital, Malmö, Sweden.
authors: Saemundur
authors: S
authors: Gudmundsson
mesh_terms: D001783:Blood Flow Velocity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000196:embryology*; D011225:Pre-Eclampsia; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D018566:Pregnancy, High-Risk; D011651:Pulmonary Artery / Q000196:embryology* / Q000648:ultrastructure*; D012016:Reference Values; D018608:Ultrasonography, Doppler / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods; D014599:Uterus / Q000098:blood supply