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Differentiated evaluation of blood flow middle cerebral artery in relation to the fetal well‐being
Author(s) -
Rozpravka P.,
Ostro A.
Publication year - 2001
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2001.abs27-7.x
Subject(s) - medicine , middle cerebral artery , fetus , in utero , cerebral arteries , cerebral blood flow , anterior cerebral artery , cardiology , pregnancy , ischemia , biology , genetics
Objective: To state clinical signification of differentiated evaluation Doppler velocimetry middle cerebral artery (MCA) of ultrasonographically detected intrauterine growth retarded (IUGR) fetuses, during pregnancies complicated hypertension (PIH) and pre‐eclampsia. Methods: In prospective, comparative clinical studies evaluated Doppler velocimetric curve MCA separately in proximal (basal) segment (PS) and distal (cortical) anatomical segment (DS). Values of pulsatility index (PI) were compared in proximal and distal segment MCA. Corticocerebral index (CCI) was stated as ratio PIPS/PIDS. Results were compared in the group‐A with IUGR detected and in control group‐B with normal growth of the fetuses. Period of measurements complex biometry was l week, fetal flowmetry minimally 24 h, maximally l week. Results: Values of PI in PS and DS MCA were significantly different. Resistance of MCA in cortical direction decrease. Values of PIPS were higher comparing PIDS. We found statistically significant correlation CCI and >1 and chronical fetal hypoxy resulted in IUGR. Differentiated flow analysis of MCA did not show statistically significant differences of PIPS and PIDS. Calculated CCI = 1. MCA resistance does not show changes in cortical direction. We found significantly higher statistical occurrence of perinatal complications of the fetuses, elective cesarean sections for fetal intrauterine hypoxy, when values of CCI and >1. This is the fact concluded worse prognosis of the fetuses with cortical sparing effect in utero , but also worse postnatal adaptation. Main outcome – corticocerebral index is simple parameter for detection of different saturation of the brain of the fetus under hypoxemia. Fetal prosperity in utero has coming worse during cortical preservation. There is significantly higher occurrence of perinatal complications.