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© 2007 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 26:1013-1017 • 0278-4297

Middle Cerebral Artery Peak Systolic Velocity of Healthy Fetuses in the First Half of Pregnancy

Theera Tongsong, MD, Chanane Wanapirak, MD, Supatra Sirichotiyakul, MD, Fuanglada Tongprasert, MD and Kasemsri Srisupundit, MD

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Address correspondence to Theera Tongsong, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. E-mail: ttongson{at}mail.med.cmu.ac.th

Objective. The purpose of this study was to establish normative data of middle cerebral artery (MCA) peak systolic velocity (PSV) in the first half of normal pregnancies (11–22 weeks). Methods. A prospective cross-sectional descriptive study was conducted in which low-risk pregnant women whose pregnancies were singleton with accurate gestational age were recruited into the study. All neonates were subsequently proven to be healthy at birth. The sonographic measurements of MCA PSV were performed by the same examiner with a high-resolution machine. Results. The total number of measurements was 410, and the number of measurements for each gestational week ranged from 30 to 40. The best regression model between gestational week and placental thickness was observed to be a linear function, and reference curves were constructed. The results showed a continuous increase in MCA PSV over the period from 11 to 22 weeks. During the period of study, 3 fetuses with hemoglobin Bart disease in the first half of pregnancy were encountered, and all of them had PSV of greater than the 95th percentile as well as 1.5 multiples of the median for each gestational week. Conclusions. A nomogram of MCA PSV for each gestational age from 11 to 22 weeks was constructed. These reference ranges may be useful noninvasive tools in risk assessment for fetal anemia in early pregnancy, especially due to hemoglobin Bart disease.

Key Words: Doppler velocity • hemoglobin Bart disease • fetal anemia • middle cerebral artery • sonography

Abbreviations: Hb, hemoglobin • MCA, middle cerebral artery • MOM, multiples of the median • PSV, peak systolic velocity

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Copyright © 2007 by the American Institute of Ultrasound in Medicine.