Doppler reference values of the fetal vertebral and middle cerebral arteries, at 19-41 weeks gestation

J Matern Fetal Neonatal Med. 2015 Feb;28(3):338-43. doi: 10.3109/14767058.2014.916680. Epub 2014 May 22.

Abstract

Objectives: Blood flow to the fetal brain is supplied by two vascular systems: the vertebral artery (VA) and the internal carotid artery with its anatomical continuation, the middle cerebral artery (ICA/MCA). In this work, our aim was to establish consistent reference values for the comparative study of both arterial systems.

Methods: The study group consisted of 2323 Doppler examinations of the VA, MCA and UA performed on 2323 single pregnancies between 19 and 41 weeks. These values were afterwards used to calculate the pulsatility index (PI), peak systolic velocity (PSV) and cerebro-placental ratio (CPR) percentiles.

Results: The VA and MCA PI reached maximum values at the end of the second trimester and decreased afterwards due to an increase in the diastolic flow. Conversely, the VA and MCA PSV increased progressively until the end of pregnancy. Regarding the VA and MCA CPR values, they were higher in the middle of the third trimester and decreased afterwards.

Conclusions: In both arterial systems, Doppler reference values have been calculated for the PI, PSV and CPR, being available for future comparative studies.

Keywords: Fetal brain; fetal middle cerebral artery Doppler; fetal vertebral artery Doppler.

Publication types

  • Comparative Study

MeSH terms

  • Blood Flow Velocity
  • Brain / blood supply*
  • Female
  • Gestational Age
  • Humans
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / physiology*
  • Pregnancy
  • Pregnancy Trimester, Second
  • Reference Values
  • Ultrasonography, Doppler / methods
  • Ultrasonography, Prenatal / methods*
  • Vertebral Artery / diagnostic imaging
  • Vertebral Artery / physiology*