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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:1405-1408 • 0278-4297

Middle Cerebral Artery Blood Flow Velocimetry Among Healthy Fetuses With a Single Umbilical Artery

Reli Hershkovitz, MD, Eyal Sheiner, MD and Moshe Mazor, MD

Ultrasound Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Address correspondence to Reli Hershkovitz, MD, Ultrasound Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, PO Box 151, 84101 Beer-Sheva, Israel. E-mail: ralikah{at}bgumail.bgu.ac.il

Objective. A single umbilical artery (SUA) is an independent risk factor for perinatal morbidity and mortality in healthy fetuses. The aims of the study were (1) to determine middle cerebral artery (MCA) blood flow velocimetric values among fetuses without structural or chromosomal anomalies with an SUA and to compare them with nomograms of patients with a 3-vessel cord and (2) to measure the pulsatility index (PI) of the umbilical artery among these patients. Methods. The PI values of the MCA and umbilical arteries were determined prospectively among 98 healthy fetuses with an SUA. The PI values were compared with nomograms of patients with a 3-vessel umbilical cord. For the MCA, peak systolic velocity (PSV) was also measured. Patients carrying fetuses with intrauterine growth restriction or congenital anomalies were excluded from the study. Middle cerebral artery PI values below the fifth percentile and PSV values above the 95th percentile adjusted for gestational age were considered abnormal. Results. Gestational age ranged between 22 and 37.9 weeks (median, 30.3 weeks). After adjusting for gestational age, no alterations in the MCA PI and umbilical PI were found in comparison with the normal range for a 3-vessel cord known in the literature. Middle cerebral artery PSV values were also within the normal range for gestational age in all patients. Conclusions. The MCA PI and PSV values among healthy fetuses with an isolated SUA were similar to nomograms for fetuses with a 3-vessel umbilical cord. Therefore, abnormal MCA PI and PSV values among fetuses with an SUA should be treated the same as in patients with a 3-vessel umbilical cord.

Key Words: blood flow velocimetry • middle cerebral artery • single umbilical artery

Abbreviations: IUGR, intrauterine growth restriction • MCA, middle cerebral artery • PI, pulsatility index • PSV, peak systolic velocity • SUA, single umbilical artery • UA, umbilical artery

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.