Fetal and Neonatal Middle Cerebral Artery Hemodynamic Changes and Significance under Ultrasound Detection in Hypertensive Disorder Complicating Pregnancy Patients with Different Severities

Abstract

Colour Doppler ultrasound was applied for monitoring the hemodynamic parameters of fetal uterine artery (UtA), umbilical artery (UA), and middle cerebral artery (MCA) during pregnancy. In hypertension disease complicating pregnancy, these hemodynamic measures and their therapeutic applicability value were reviewed (HDCP). 120 singleton pregnant women were chosen, with 40 cases of mild preeclampsia (mild group), 40 cases of severe preeclampsia (severe group), and 40 normal control pregnant women (control group). The hemodynamic parameters of UtA, MCA, and UA were monitored in the three groups, including pulsatility index (PI), resistance index (RI), and the systolic/diastolic velocity (S/D). The parameters PI, RI, S/D, and venous catheter shunt rate (Qdv/Quv) of UtA and UA in the severe group were higher than those in the normal group and the mild group, showing the differences statistically significant ( P < 0.05 ). The PI, RI, and S/D of MCA in the severe group were lower than those in the normal group and the mild group ( P < 0.05 ). The changing trends of PI, RI, and S/D in the severe group were all first increased and then decreased in the early, middle, and later pregnancy ( P < 0.05 ). The area under the curve (AUC) was 0.98 in the receiver operating characteristic (ROC) curve created using a combination of hemodynamic measures and pregnancy outcomes, and the sensitivity and specificity for predicting bad outcomes were 94.7 percent and 96.4 percent, respectively. Colour Doppler ultrasound may accurately detect changes in the PI, RI, and S/D of UtA, MCA, and UA in pregnant women and serve as a reference for determining the intrauterine state of the fetuses and predicting bad pregnancy outcomes. In particular, the parameters in later pregnancy were higher worthy of diagnostic value for adverse pregnancy outcomes. The combination of various parameters could make an improvement of the diagnostic accuracy and provide a basis for guiding treatment as well as determining the optimal timing of delivery.

Correlation Between Fetal Umbilical Artery and Middle Cerebral Artery Doppler Indices in Preeclamptic and Normotensive Pregnancies

“…Lopez-Mendez et al 15 revealed a mean MCA PI of 1.47 ± 0.29, a mean MCA RI of 0.69 ± 0.06, and a mean MCA S/D ratio of 5.34 ± 0.67 in the preeclamptic group. In the study by Zhou et al, 19 blood flow parameters (PI, RI, and S/D ratio) of MCA gradually decreased in the preeclamptic group compared with the normotensive group, and all differences were significant ( P < .05). These findings align closely with the results reported in this study.…”

“…Lopez-Mendez et al 15 reported on 52 of 103 preeclamptic pregnancies, and the UA PI mean of the cohort was 1.31 ± 0.18, a UA RI mean of 0.77 ± 0.09, and a UA S/D ratio mean of 4.4 ± 0.54. In addition, Zhou et al 19 reported higher blood flow parameters (PI, RI, and S/D ratio) in the preeclamptic group than in the normotensive group, with all differences being significant ( P < .05). Zhou et al’s findings align well with our study findings.…”

Giá Trị Siêu Âm Doppler Động Mạch Rốn, Động Mạch Não Giữa Trong Tiên Lượng Sức Khoẻ Thai Nhi Ở Thai Phụ Tiền Sản Giật Tại Bệnh Viện Phụ Sản Thành Phố Cần Thơ Năm 2021 - 2023

“…Độ đặc hiệu tại điểm cắt này của chúng tôi giống với nghiên cứu của Trương Thị Linh Giang nhưng độ nhạy phát hiện bệnh thấp hơn nhiều. Pei Zhou cũng nghiên cứu trên 80 thai phụ tiền sản giật cũng tìm được điểm cắt tiên lượng kết cục bất lợi thai kỳ là 0,68 với độ nhạy cao 89,4%, nhưng độ đặc hiệu chỉ 58,7% [9]. Theo Ranjumoni Konwar (2021), giá trị của RI ĐMNG trong dự đoán kết cục chu sinh có độ nhạy 66,7%, độ đặc hiệu 70,6%, độ chính xác 68% (p = 0,01) [10].…”