Journal of Ultrasound in Medicine, Vol 8, Issue 5 237-240, Copyright © 1989 by American Institute of Ultrasound in Medicine
Prenatal cerebral Doppler ultrasonography and neonatal neurologic outcome
G. Rizzo, D. Arduini, R. Luciano, C. Rizzo, G. Tortorolo, C. Romanini and S. Mancuso
Ist. Cl. Ostetrica e Ginecologica, Universita Cattolica S. Cuore, Roma, Italy.
The significance of fetal cerebral blood flow analysis in the prediction of
neonatal neurologic outcome was investigated on 87 fetuses at risk for
chronic hypoxia. Blood flow velocity waveforms were recorded from the fetal
internal carotid artery immediately before cesarean section; newborns
underwent neurologic follow-up until discharged from the neonatal division.
Neonatal outcome was considered abnormal in presence of a postasphyxial
encephalopathy. Receiver operating characteristic curves were used to
demonstrate the efficacy of fetal cerebral blood flow velocity waveform
analysis as a predictor of neonatal outcome. A value of the pulsatility
index from the internal carotid artery below the second standard deviation
of our range of normality was found to be a powerful indicator of the
development of neonatal neurologic abnormalities (Cohen's Kappa index =
.58). These results were particularly evident in fetuses with a birthweight
above 2500 g in which a specificity of 93.7%, a sensitivity of 75%, and an
accuracy of 89.7% were achieved.
