Anthony E Swartz1, Michael S Ruma, Eunhee Kim, Amy H Herring, M Kathryn Menard, Kenneth J Moise. 1. From the Department of Maternal-Fetal Medicine, WakeMed Faculty Physicians, Raleigh, North Carolina; Perinatal Associates of New Mexico, Albuquerque, New Mexico; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina; Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Baylor College of Medicine, and the Texas Children's Fetal Center, Texas Children's Hospital, Houston, Texas.
Abstract
OBJECTIVE: To estimate the effect of an increase in the basal heart rate of the fetus on the middle cerebral artery peak systolic velocity (MCA-PSV). METHODS: This was a prospective longitudinal cohort. Patients between 14 and 36 weeks of gestation were enrolled (N=66). Ultrasound examinations were performed monthly. MCA-PSV measurements were assessed at 0-degree angle of insonation at basal fetal heart rate and after application of vibroacoustic stimulation. RESULTS: A total of 514 MCA-PSV measurements were obtained in 66 fetuses. No difference in fetal heart rate before and after vibroacoustic stimulation was noted before 27 weeks of gestation. A significant increase in fetal heart rate after vibroacoustic stimulation was detected from a mean+/-standard deviation gestational age of 27.1+/-1.3 weeks onward. A significant decrease in the MCA-PSV was noted between before vibroacoustic stimulation and after vibroacoustic stimulation measurements for examinations 3,4, and 5 (P<.001 for all). CONCLUSION: Acceleration of the fetal heart rate in the third trimester is associated with a decrease in the middle cerebral artery peak systolic velocity. Assessment of the MCA-PSV for the detection of fetal anemia, particularly in the third trimester, should be undertaken during a period of baseline fetal heart rate to avoid the potential of a false-negative result. LEVEL OF EVIDENCE: II.
OBJECTIVE: To estimate the effect of an increase in the basal heart rate of the fetus on the middle cerebral artery peak systolic velocity (MCA-PSV). METHODS: This was a prospective longitudinal cohort. Patients between 14 and 36 weeks of gestation were enrolled (N=66). Ultrasound examinations were performed monthly. MCA-PSV measurements were assessed at 0-degree angle of insonation at basal fetal heart rate and after application of vibroacoustic stimulation. RESULTS: A total of 514 MCA-PSV measurements were obtained in 66 fetuses. No difference in fetal heart rate before and after vibroacoustic stimulation was noted before 27 weeks of gestation. A significant increase in fetal heart rate after vibroacoustic stimulation was detected from a mean+/-standard deviation gestational age of 27.1+/-1.3 weeks onward. A significant decrease in the MCA-PSV was noted between before vibroacoustic stimulation and after vibroacoustic stimulation measurements for examinations 3,4, and 5 (P<.001 for all). CONCLUSION: Acceleration of the fetal heart rate in the third trimester is associated with a decrease in the middle cerebral artery peak systolic velocity. Assessment of the MCA-PSV for the detection of fetal anemia, particularly in the third trimester, should be undertaken during a period of baseline fetal heart rate to avoid the potential of a false-negative result. LEVEL OF EVIDENCE: II.
Authors: Bahauddin I Sallout; Karen Fung Kee Fung; Shi W Wen; Laura M Medd; Mark C Walker Journal: Am J Obstet Gynecol Date: 2004-10 Impact factor: 8.661
Authors: Michael S Ruma; Anthony E Swartz; Eunhee Kim; Amy H Herring; M Kathryn Menard; Kenneth J Moise Journal: Am J Obstet Gynecol Date: 2009-04 Impact factor: 8.661
Authors: G Mari; R L Deter; R L Carpenter; F Rahman; R Zimmerman; K J Moise; K F Dorman; A Ludomirsky; R Gonzalez; R Gomez; U Oz; L Detti; J A Copel; R Bahado-Singh; S Berry; J Martinez-Poyer; S C Blackwell Journal: N Engl J Med Date: 2000-01-06 Impact factor: 91.245
Authors: Dick Oepkes; P Gareth Seaward; Frank P H A Vandenbussche; Rory Windrim; John Kingdom; Joseph Beyene; Humphrey H H Kanhai; Arne Ohlsson; Greg Ryan Journal: N Engl J Med Date: 2006-07-13 Impact factor: 91.245
Authors: G Mari; A Adrignolo; A Z Abuhamad; J Pirhonen; D C Jones; A Ludomirsky; J A Copel Journal: Ultrasound Obstet Gynecol Date: 1995-06 Impact factor: 7.299