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[Fetal doppler flow velocimetry measurements as indications for cesarean section].

W Mizgiert, Mariola Czajkowska, Z Sych, R. Czajka

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Abstract

An effort was made to analyze fetal umbilical and cerebral arteries Doppler flow velocimetry patterns in pregnancies terminated with cesarean section emphasizing risk to the fetus. The flow velocimetry measurements were carried out at least 7 days prior to deliveries. The incidence of abnormal values of flow indices (SD, RI i PI) and ratio (CPR) were compared in pregnant women who delivered by cesarean section due to: I--threatening fetal distress (n = 28)--elective cesarean sections were performed on pregnant women with chronic placental insufficiency symptoms; II--fetal distress (n = 22)--emergency cesarean sections; III--obstetric indications for cesarean section (no symptoms of fetal distress were present). Increased resistance in placental circulation, and decreased resistance in cerebral vessels finally leading to reversed diastolic umbilical flow occur more often in pregnant women with chronic placental insufficiency. Umbilical factor seems to be responsible for the observed in every studied group higher incidence of abnormal flows in middle cerebral than in umbilical artery. Fetal Doppler flow velocimetry of umbilical and middle cerebral arteries allow for finding of the most proper time of high-risk pregnancy termination, hence should be considered in the elective cesarean sections.

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What this paper is about

An effort was made to analyze fetal umbilical and cerebral arteries Doppler flow velocimetry patterns in pregnancies terminated with cesarean section emphasizing risk to the fetus. The flow velocimetry measurements were carried out at least 7 days prior to deliveries. The incidence of abnormal values of flow indices (SD, RI i PI) and ratio (CPR) were compared in pregnant women who delivered by cesarean section due to: I--threatening fetal distress (n = 28)--elective cesarean sections were performed on pregnant women with chronic placental insufficiency symptoms; II--fetal distress (n = 22)--emergency cesarean sections; III--obstetric indications for cesarean section (no symptoms of fetal distress were present). Increased resistance in placental circulation, and decreased resistance in cerebral vessels finally leading to reversed diastolic umbilical flow occur more often in pregnant women with chronic placental insufficiency. Umbilical factor seems to be responsible for the observed in every studied group higher incidence of abnormal flows in middle cerebral than in umbilical artery. Fetal Doppler flow velocimetry of umbilical and middle cerebral arteries allow for finding of the most proper time of high-risk pregnancy termination, hence should be considered in the elective cesarean sections.

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Available abstract

An effort was made to analyze fetal umbilical and cerebral arteries Doppler flow velocimetry patterns in pregnancies terminated with cesarean section emphasizing risk to the fetus. The flow velocimetry measurements were carried out at least 7 days prior to deliveries. The incidence of abnormal values of flow indices (SD, RI i PI) and ratio (CPR) were compared in pregnant women who delivered by cesarean section due to: I--threatening fetal distress (n = 28)--elective cesarean sections were performed on pregnant women with chronic placental insufficiency symptoms; II--fetal distress (n = 22)--emergency cesarean sections; III--obstetric indications for cesarean section (no symptoms of fetal distress were present). Increased resistance in placental circulation, and decreased resistance in cerebral vessels finally leading to reversed diastolic umbilical flow occur more often in pregnant women with chronic placental insufficiency. Umbilical factor seems to be responsible for the observed in every studied group higher incidence of abnormal flows in middle cerebral than in umbilical artery. Fetal Doppler flow velocimetry of umbilical and middle cerebral arteries allow for finding of the most proper time of high-risk pregnancy termination, hence should be considered in the elective cesarean sections.

Key concepts: Fetal distress, Medicine, Umbilical artery, Velocimetry, Middle cerebral artery, Obstetrics, Fetus, Placental Circulation

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