Doppler Waveform Indices of Fetal Middle Cerebral Artery in Normal 20 to 40 Weeks Pregnancies

Background: One of the main methods for evaluation of fetal well-being is analysis of Doppler flow velocity waveform of fetal vessels. Evaluation of Doppler wave of the middle cerebral artery can predict most of the at-risk fetuses in high-risk pregnancies. In this study, we tried to determine the normal ranges and their trends during pregnancy of Doppler flow velocity indices (resistive index, pulsatility index, systolic-to-diastolic ratio, and peak systolic velocity) of middle cerebral artery in 20 - 40 weeks normal pregnancies in Iranians. Methods: In this cross-sectional study, 1037 women with normal pregnancy and gestational age of 20 to 40 weeks were investigated for fetal middle cerebral artery Doppler examination. Results: Resistive index, pulsatility index, and systolic-to-diastolic ratio values of middle cerebral artery decreased in a parabolic pattern while the peak systolic velocity value increased linearly with progression of the gestational age. These changes were statistically significant (P<0.001 for all four variables) and were more characteristic during late weeks of pregnancy. The mean fetal heart rate was also significantly (P<0.001) reduced in correlation with the gestational age. Conclusion: Doppler waveform indices of fetal middle cerebral artery are useful means for determining fetal well-being. Herewith, the normal ranges of Doppler waveform indices for an Iranian population are presented.