scholarly journals OP04.09: Umbilical artery and middle cerebral artery Doppler abnormalities during fetal myelomeningocele repair: drug‐induced waveform changes?

2021 ◽  
Vol 58 (S1) ◽  
pp. 71-72
Author(s):  
M. Gonser ◽  
L. Vonzun ◽  
U. Moehrlen ◽  
L. Mazzone ◽  
M. Meuli ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Drug Induced ◽  
Myelomeningocele Repair

scholarly journals P12.05: Doppler changes in umbilical artery, middle cerebral artery and ductus venosus during fetal myelomeningocele repair through a mini hysterotomy

2019 ◽  
Vol 54 (S1) ◽  
pp. 192-193
Author(s):  
R. Cruz‐Martinez ◽  
M. Martinez‐Rodriguez ◽  
A. Gamez‐Varela ◽  
M. Cruz Lemini ◽  
K. Aguilar‐Vidales ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Myelomeningocele Repair

USING DOPPLER TO ASSESS THE FETAL HEALTH FOR THE PREDICTION OF GESTATIONAL OUTCOME

2014 ◽  
pp. 9-18
Author(s):  
Thi Linh Giang Truong ◽  
Vu Quoc Huy Nguyen
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Functional Method ◽  
Invasive Technique ◽  
Routine Practice ◽  
Fetal Health ◽  
Uterine Arteries ◽  
Non Invasive ◽  
Key Words Doppler

Background: Assessment of fetal health plays the most important role in prenatal care because of influence of the prediction of gestational outcome. One of the main aims of routine antenatal care is to identify the ‘ at risk ‘ fetus in order to apply clinical interventions which could results in reduced perinatal morbidity and mortality. Doppler ultrasound is a non invasive technique whereby the movement of blood is studied by detecting the change in frequence of reflected sound, Doppler blood flow velocity waves form of fetal side (umbilical artery, middle cerebral artery ...) and maternal side ( uterine arteries) are discussed and monograms for routine practice are presented. Recently this method is important tool for qualifying high risk pregnancies and help early forecasts the health of the babies and mothers disorder. Doppler sonography in obstetrics is a widely accepted functional method of examining the prediction of gestational outcome. Key words: Doppler, umbilical artery, middle cerebral artery, uterine arteries

scholarly journals The role of sildenafil citrate in the treatment of fetal growth restriction: a randomized controlled trial

2019 ◽  
Vol 8 (5) ◽  
pp. 1840
Author(s):  
Ahmed Abdelshafy ◽  
Khaled Ibrahim Abdullah ◽  
Sherif Ashoush ◽  
Heba E. Hosni
Keyword(s):  
Middle Cerebral Artery ◽  
Fetal Growth ◽  
Cerebral Artery ◽  
Fetal Growth Restriction ◽  
Umbilical Artery ◽  
Controlled Trial ◽  
Maternity Hospital ◽  
Growth Restriction ◽  
Sildenafil Citrate ◽  
Doppler Velocity

Background: This study was aimed to evaluate the effect of sildenafil citrate on Doppler velocity indices in patients with fetal growth restriction (FGR) associated with impaired placental circulation.Methods: A double-blinded, parallel group randomized clinical trial (clinicaltrials.gov NCT02590536) was conducted in Ain Shams Maternity Hospital, in the period between October 2015 and June 2017. Ninety pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were randomized to either sildenafil citrate 25 mg orally every 8 hours or placebo visually-identical placebo tablets with the same regimen. The primary outcome of the study was the change in umbilical artery and fetal middle cerebral artery indices.Results: There was a significant improvement in umbilical and middle cerebral artery indices after sildenafil administration p<0.001. Present study observed that, sildenafil group, in comparison to placebo, has a significantly higher mean neonatal birth weight. 1783±241g vs 1570±455g (p<0.001). There was a significantly higher mean gestational age at delivery in women in sildenafil group 35.3±1.67 weeks, whereas it was lower in the placebo group 33.5±1.7 weeks. The side effects as headache, palpitation and facial flushing were significantly higher in sildenafil group compared to placebo group.Conclusions: The use sildenafil citrate in pregnancies with fetal growth restriction (FGR) improved the feto-placental Doppler indices (pulsatility index of umbilical artery and middle cerebral artery) and improved neonatal outcomes.

scholarly journals Differences in Biometric Fetal Weight Estimation Accuracy and Doppler Examination Results in Uncomplicated Term Singleton Pregnancies between Vertex and Breech Presentation

2021 ◽  
Vol 10 (15) ◽  
pp. 3252
Author(s):  
Lukas Jennewein ◽  
Simon Theissen ◽  
Hemma Roswitha Pfeifenberger ◽  
Nadja Zander ◽  
Kyra Fischer ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Breech Presentation ◽  
Fetal Weight ◽  
Estimation Accuracy ◽  
Weight Estimation ◽  
Fetal Weight Estimation ◽  
Presentation Group ◽  
Chi2 Test

Doppler examination of the umbilical artery and the fetal middle cerebral artery is evaluated predominantly in pregnancies with fetuses in cephalic presentation and never has been elucidated in breech presentation. Evidence on the accuracy of fetal weight estimation in dependence of the fetal presentation is controversial. Nevertheless, clinical decisions including recommendations for a cesarean section or labor induction based on these examinations are applied to pregnancies with fetuses in breech presentation. The objective of this study was to investigate the influence of the fetal presentation on fetal weight estimation accuracy, umbilical artery and middle cerebral artery resistance indices (RI) in a prospective case control study. Ultrasound examinations in 305 uncomplicated term pregnancies (153 vertex presentations, 152 breech) were investigated. Non-parametric variables were compared using Pearson’s chi2 test and Wilcoxon chi2 test, depending on variable scaling. Fetal weight estimation accuracy was not significantly different between vertex presentation group (VP) (6.97%) and breech presentation group (BP) (7.96%, p = 0.099). Fetal head circumference measurements were significantly larger in BP (350 mm vs. 341 mm in VB, p > 0.0001) while abdominal circumferences were significantly smaller (VP: 338 mm, BP: 331 mm, p = 0.0039) and weight estimation was not significantly different. Umbilical artery RIs were not significantly different between VP (54.5) and BP (55.3, p = 0.354). Fetal middle cerebral artery RIs also showed no significant differences (VP: 71.2, BP: 70.7, p = 0.335). Our study shows that fetal Doppler (RI) and weight estimation ultrasound originally calibrated in cephalic pregnancies are applicable to pregnancies with fetuses in breech presentation.

scholarly journals Doppler ultrasound in pregnancy – quality requirements of DEGUM and clinical application (part 2)

2021 ◽  
Author(s):  
Renaldo Faber ◽  
Kai-Sven Heling ◽  
Horst Steiner ◽  
Ulrich Gembruch
Keyword(s):  
Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Umbilical Artery ◽  
Prophylactic Treatment ◽  
Doppler Sonography ◽  
First Trimester ◽  
Ductus Venosus ◽  
Fetal Diagnosis

AbstractThis second part on Doppler sonography in prenatal medicine and obstetrics reviews its clinical applications. While this has not become the initially anticipated screening tool, it is used for the diagnosis and surveillance of a variety of fetal pathologies. For example, the sonography-based determination of uterine artery blood flow indices is an important parameter for the first trimester multimodal preeclampsia risk assessment, increasing accuracy and providing indication for the prophylactic treatment with aspirin. It also has significant implications for the diagnosis and surveillance of growth-restricted fetuses in the second and third trimesters through Doppler-sonographic analysis of umbilical artery, middle cerebral artery and ductus venosus. Here, especially the hemodynamics of the ductus venosus provides a critical criterium for birth management of severe, early-onset FGR before 34 + 0 weeks of gestation. Further, determination of maximum blood flow velocity of the middle cerebral artery is a central parameter in fetal diagnosis of anemia which has been significantly improved by this analysis. However, it is important to note that the mentioned improvements can only be achieved through highest methodological quality. Importantly, all these analyses are also applied to twins and higher order multiples. Here, for the differential diagnosis of specific complications such as TTTS, TAPS and TRAP, the application of Doppler sonography has become indispensable. To conclude, the successful application of Doppler sonography requires both exact methodology and precise pathophysiological interpretation of the data.

scholarly journals The study of arterial and venous Doppler in high risk pregnancies and its role in perinatal outcome

2018 ◽  
Vol 7 (3) ◽  
pp. 1116
Author(s):  
S. Tabitha ◽  
Madishetti Rajini
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Ductus Venosus ◽  
Delivery Mode ◽  
Care Hospital

Background: Antepartum foetal surveillance is the corner stone in the management of high risk pregnancies, aimed at reducing maternal and perinatal mortality and morbidity. This study was conducted to analyse the blood flow in umbilical artery, middle cerebral artery, umbilical vein and ductus venous using doppler ultrasound in high risk pregnancies.Methods: This was a prospective study conducted in pregnant patients with high risk factors after 28 weeks of gestation who got admitted in the Department of Obstetrics and Gynaecology at Care Hospital, Hyderabad during the period from October 2013 to December 2014.Results: Patients were divided into two groups, first with normal Doppler and second with abnormal Doppler, containing 76 and 20 patients respectively. Group 2 is again 4 sub-groups according to the vessel affected. Group A included the cases with affected umbilical artery, Group B included the cases with affected middle cerebral artery, Group C included the cases with both affected umbilical artery and middle cerebral artery (UA+MCA), Group D included the Cases with the affected umbilical artery, middle cerebral artery and Ductus Venosus (UA+MCA+DV) containing 12, 2, 4 and 2 patients respectively. There were more number of emergency caesarean sections than vaginal deliveries which is statistically significant (p <0.034), there were more number of sick babies than healthy babies and there are more number of still births which is statistically significant (p <0.0001), there are more number of low birth weight babies in comparison to normal weight, which is statistically significant (p <0.0037). Distribution of cases with abnormal Doppler depending on vessel abnormality according to gestational age at the time of delivery, mode of delivery, perinatal outcome, birth weight, which was statistically significant. The sensitivity and specificity of abnormal Doppler in predicting perinatal outcome is 45% with (95% CI 26.9-64.0) and 89.5% with (95% CI 79.0-95.3) respectively. The positive predictive value is 65% with (95% CI 40.9-83.6) and negative predictive value is 78.9% with (95% CI 67.7-87.1).Conclusions: This study recommends that all high risk pregnant women should undergo serial foetal monitoring. When doppler abnormalities are detected, delivery should be conducted at a tertiary care centre where facilities for caesarean section and NICU are present.

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