The blood flow changes of middle cerebral artery in predicting perinatal outcome of fetus with nuchalcord.

Objective:To investigate the value of the blood flow changes of middle cerebral artery(MCA) in predicting adverse outcome of fetuses with nuchalcord.Methods:From January 2006 to September 2006,51 women who delivered at term were studied.39 of them who were complicated with nuchalcord and had vaginal deliveries were devided into two groups according to fetal outcome.Group 1 included 15 cases with fetal distress.Group 2 included 24 cases with favorable fetal outcome.A control group included 12 women who were health pregnant women without nuchal coiling of the umbilical cord and had normal vaginal deliveries.Before labour and during early-active labour,blood flow impedance of fetal middle cerebral artery MCA was assessed by means of color Doppler ultrasonography and measured by the peak-systolic/diastolic ratio(S/D),pulse index(PI)and resistance index(RI).Results:(1)Before labour,the S/D,RI,PI values of fetal MCA in group 1 were significantly higher than those in group 2 and control group,however,there was no significant difference in these parameters between group 2 and control group.(2) In active labour,the S/D,RI,PI values of fetal MCA in fetus with were significantly lower than those in group 2 and control group,however,there was no significant difference in these parameters between group 2 and control group.Conclusions:This study showed the blood flow changes of fetal MCA are closely associated with adverse fetal outcomes.Examination of fetal blood flow in MCA is a valuable method in predicting adverse perinatal outcome of fetal with nuchalcord.