Middle cerebral artery Doppler pulsatility index as a predictor of intrapartum meconium release in prolonged pregnancies

J Neonatal Perinatal Med. 2020;13(3):339-344. doi: 10.3233/NPM-190232.

Abstract

Objectives: The aim of this study was to asses the correlation of middle cerebral artery pulsatility index (MCA-PI) and perinatal outcomes in prolonged pregnancies.

Study design: This was a prospective study of all consecutive pregnant women beyond 41 weeks' gestation attending for obstetric surveillance during a two years period. We evaluated the predictive value of MCA-PI lower than the 5th percentile (<p5) and the occurrence of: cesarean delivery for fetal distress, 5-min Apgar score <7, arterial cord pH < 7.15, presence of thick meconium at delivery, need for admission to the neonatal intensive care and/or neonatal death.

Results: Three hundred and one pregnancies met the inclusion criteria and were managed expectantly. Of them, 31 (10.3%) fetuses had an MCA-PI < p5, which showed a significant relationship with the presence of thick meconium at birth (p < 0.001), but was not related to any of the other perinatal outcomes.

Conclusion: In prolonged pregnancies, the finding of MCA-PI < p5 is related to meconium emission at the time of delivery, but is not associated with an increased risk of adverse perinatal outcome.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Female
  • Fetal Distress* / diagnosis
  • Fetal Distress* / etiology
  • Humans
  • Infant, Newborn
  • Meconium*
  • Middle Cerebral Artery* / diagnostic imaging
  • Middle Cerebral Artery* / physiopathology
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Pregnancy, Prolonged* / epidemiology
  • Pregnancy, Prolonged* / physiopathology
  • Pulsatile Flow*
  • Spain / epidemiology
  • Ultrasonography, Doppler / methods*