Reduction of Doppler indexes in the Middle Cerebral Artery in
uncomplicated pregnancies at 40 weeks and beyond. What does it mean?
Abstract
Objective The aim of our data is reveal correlation between Doppler in
the Middle Cerebral Artery and fetal suffering during labor in
uncomplicated pregnancies at 40 weeks and beyond. Design 1020
uncomplicated pregnant women at 40 weeks and beyond were examined by
Doppler 48 hours before delivery. Population 260 women were included in
the study because they met the inclusion criteria. Methods All women
were divided into 2 groups according to fetus distress during labor
(vaginal delivery and emergency Cesarean Section caused by fetal
distress). And according to newborn’s condition just after delivery
(Apgar score <=7 and >7 on the 1st minute) Result
In group of women with caesarean section caused by fetal distress
pulsatility indexes were significant lower, than in group of women with
vaginal labor (PI=1,12 and 0,98 respectively P< 0,01; CPR 1,44
and 1,26 respectively P< 0,01). We found out trigger level for
pulsatility indexes as 0.835, if pulsatility indexes less 0.835 we have
adverse perinatal outcome during labor. When PI =< 0,835 fetal
distress were in 66,7% cases, if PI > 0,835 in 39,1%
cases (P<0,001;OR= 3,1). When PI =< 0,835 newborns
had Apgar =< 7 in 37,5% and Apgar more than 8 in 20,3%
(P< 0,01;OR-2,3) Conclusion Pulsatility indexes in Middle
Cerebral Artery can be an indicator of fetal distress and can be useful
as a marker of its poor outcome. On the basis of these, it is possible
to identify groups of risk of women with gestation age of more than 40
weeks.