Abnormal Middle Cerebral Artery Doppler Associates with Spontaneous Preterm Birth in Normally Grown Fetuses

Silvia Salvi, José Morales-Roselló, Asma Khalil, Sylvia Salvi, Rosemary Townsend, Yaami Premakumar, Alfredo Perales-Marín

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Objective: Our aim was to evaluate whether Doppler changes in the fetal middle cerebral (MCA) and umbilical arteries (UA) suggesting fetal hypoxemia precede the onset of spontaneous preterm birth (PTB). Methods: We studied 2,340 appropriate-for-gestational-age singleton pregnancies that had MCA and UA pulsatility indices (PI) recorded at 28-32 weeks. Values including the cerebroplacental ratio (CPR) were converted into multiples of the median and evaluated according to both gestational age at the onset of labor and the interval between ultrasound and labor. ROC analysis was used to calculate the ability in the prediction of spontaneous PTB before 32, 34 and 37 weeks' gestation. Results: While no correlations were observed for the UA PI and CPR, lower MCA PI values were associated with an earlier onset of labor (p < 0.001) and a shorter ultrasound-labor interval (p = 0.028). The ROC analysis at different gestational ages and intervals to labor indicated that MCA PI values were poorly predictive of spontaneous PTB (all areas under the curve <0.7). Conclusions: Low MCA PI values at 28-32 weeks are associated with subsequent spontaneous PTB, indicating that fetal hypoxemia unrelated with placental disease might be implicated in the onset of labor. This association, however, is unlikely to be useful in the prediction of PTB.
Lingua originaleEnglish
pagine (da-a)41-47
Numero di pagine7
RivistaFetal Diagnosis and Therapy
Volume40
DOI
Stato di pubblicazionePubblicato - 2016

Keywords

  • Cerebroplacental ratio
  • Fetal Doppler ultrasound
  • Fetal middle cerebral artery
  • Fetal umbilical artery
  • Fetus
  • Gestational Age
  • Labor onset
  • Middle Cerebral Artery
  • Obstetric Labor, Premature
  • Pregnancy
  • Premature Birth
  • Preterm labor
  • ROC Curve
  • Umbilical Arteries

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