ROLE OF FETAL UMBILICAL AND MIDDLE CEREBRAL ARTERY DOPPLER INDICES IN DETERMINING INTRAUTERINE GROWTH RESTRICTION IN PREECLAMPTIC PREGNANCIES

Yıl 2023, , 84 - 88, 27.12.2023

Filiz Taşçı , Özlem Bilir

https://doi.org/10.55994/ejcc.1345685

Öz

Objective:To investigatetheutility of theumbilicalartery (UA) andmiddlecerebralartery (MCA) Doppler indicesandtheirratios in determiningintrauterinegrowthrestriction (IUGR) andunfavorablebirthoutcomes in preeclampticpregnancies.
MaterialandMethod:Thisprospectivestudyincluded 59 preeclampticpregnantwomenand 63 healthypregnantwomen (controls) at a gestationalweek of 31-40 whowerefollowedup at thegynecologyandobstetricsclinic of a tertiaryhospitalover a 16-month period.Aftertheevaluation of normal andpreeclampticpregnanciesusing B-Modeultrasonography, the Doppler indexvalues of the UA and MCA weredeterminedusing Doppler ultrasonography. Bydeterminingthevelocity-time wavespectraforthe UA and MCA, thesystole/diastoleratio (S/D), resistiveindex (RI), andpulsatilityindex (PI) valueswerecalculatedfollowingtheautomaticalgorithm of thedevice.
Results:The UAS/D (3.47±1.29) and UA RI (0.69±0.13) values of thepreeclampticgroupstatisticallysignificantlydifferedfromthose of thecontrols (2.50 ± 0.30 and 0.59 ± 0.06, respectively) (p<0.001). The Doppler indices of theMCAwerelower in preeclampticpregnancies (PI: 1.28±0.34, RI: 0.73±0.09), andthiswasmoreprominent in fetuseswith IUGR (p<0.001). Therewerealsosignificantdifferencesbetweenthepreeclampticandhealthycontrolgroups in terms of the UA/MCA and MCA/UA Doppler indexratios (p<0.001).
Conclusion:Non-invasive Doppler indicescan be used in combinationtoincreasediagnosticaccuracyandprevent fetal mortalityandmorbidity .

Anahtar Kelimeler

Preeclampsia, intrauterine growth restriction, doppler

Kaynakça

• 1- Campbell S, Pearche JMF, Hackett G. Qualitative Assessment of Uteroplacental Blood Flow Early Screening Test for High Pregnancies. Obstet Gynecol 1986; 68: 649.
• 2- Ducey J, Schulman H, Farmakides G. A classification of hypertension in pregnancy based on Doppler velocimetry. Am J. Obstet Gynecol 1987; 157: 680-5.
• 3- Berkowitz GS, Chitkara U. Sonographic estimation of fetal weight and Doppler analysis of umbilical artery velocimetry in prediction of intrauterine growth retardatio: A prosoective study. Am J Obstet Gynecol 1988; 158: 1149-53.
• 4- Meher S, Hernandez Andrade E, Basheer SN, Lees C. Impact of cerebral redistribution on neurodevelopmental outcome in small-for-gestational-age or growth-restricted babies: a systematic review. Ultrasound Obstet Gynecol 2015; 46: 398-404.
• 5- Gramellini D, Folli MC, Raboni S. Cerebral -Umbilical Doppler ratio as a predictor of adverse perinatal outcome. Obstet Gynecol 1992;79: 416-20.
• 6- Cruz-Martinez R, Figueras F: The role of doppler and placental screening. Best Pract Res Clin Obstet Gynaecol. 2009, 23: 845-855.
• 7- Hecher K, Bilardo CM, Stigter RH, Ville Y, Hackelöer BJ, Kok HJ, et al. Monitoring of fetuses with intrauterine growth restriction: a longitudinal study. Ultrasound Obstet Gynecol 2001; 18: 564-70.
• 8- Zimmerman P, Alback T, Koskinen J. Doppler flow velocimetry of the umbilical artery, uteroplacental arteries and fetal middle cerebral artey in prolonged pregnancy. Ult Obst Gny.1995; 5; 189-97.
• 9- Sekizuka N. Combined examination of middle cerebral artery and umbilical artery flox velocity waveforms in growth -retarded fetuses. Asia-Oceni-J-Obster-Gynecol 1993; 19: 13.
• 10- Hidar S, Zaafouri R, Bouguizane S, Chaïeb A, Jerbi M, Bibi M, et al. Prognostic value of fetal aortic isthmus Doppler waveform in intrauterine growth retardation: prospective longitudinal study. J Gynecol Obstet Biol Reprod (Paris) 2004; 33: 745-52.
• 11- Mari G, Hanif F, Kruger M, Cosmi E, Santolaya-Forgas J, Treadwell MC, et al. Middle cerebral artery peak systolic velocity: a new Doppler parameter in the assessment of growth-restricted fetuses. Ultrasound Obstet Gynecol 2007; 29: 310-6.