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© 2009 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 28:19-25 • 0278-4297

Reliability of Fetal Middle Cerebral Artery Velocity Measurements

A Randomized Controlled Trial of Sonographer Training

Erin A. S. Clark, MD, D. Yvette Lacoursiere, MD, Janice L. B. Byrne, MD, Rebecca Ponder, MD, Robert M. Silver, MD and M. Sean Esplin, MD

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Utah School of Medicine, Salt Lake City, Utah USA.

Address correspondence to Erin A. S. Clark, MD, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Utah School of Medicine, 30 N 1900 E, Suite 2B200, Salt Lake City, UT 84132 USA., E-mail: erin.clark{at}hsc.utah.edu

Objective. The purpose of this study was to determine the reliability of fetal middle cerebral artery (MCA) peak systolic velocity (PSV) measurements at a tertiary care center and to evaluate the effect of targeted training for sonographers. Methods. Six sonographers were randomized to training modules for fetal MCA PSV or amniotic fluid volume (AFV) measurements. Six fetuses of uncomplicated pregnancies were selected for participation. Middle cerebral artery and AFV measurements were obtained before and after a training module. The intraobserver and interobserver variability (reliability) was calculated with intraclass correlation coefficients and was compared between groups. Results. Administration of the MCA training module increased the number of technically adequate MCA images obtained (odds ratio, 3.95; 95% confidence interval, 1.07–14.65). The intraobserver and inter-observer variability for MCA measurements was significantly reduced after the targeted training module (P = .05). Conclusions. The reliability of fetal MCA PSV measurements improved after a targeted training program.

Key Words: Doppler sonography • fetal anemia • middle cerebral artery • peak systolic velocity • sonographer training

Abbreviations: AFI, amniotic fluid index • AFV, amniotic fluid volume • BMI, body mass index • CI, confidence interval • DVP, deepest vertical pocket • MCA, middle cerebral artery • PSV, peak systolic velocity

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Copyright © 2009 by the American Institute of Ultrasound in Medicine.