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. 2009 Jun;113(6):1225-1229.
doi: 10.1097/AOG.0b013e3181a4b4b5.

The effect of fetal heart rate on the peak systolic velocity of the fetal middle cerebral artery

Anthony E Swartz  1 , Michael S Ruma, Eunhee Kim, Amy H Herring, M Kathryn Menard, Kenneth J Moise Jr
Affiliations

The effect of fetal heart rate on the peak systolic velocity of the fetal middle cerebral artery

Anthony E Swartz et al. Obstet Gynecol. 2009 Jun.

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.

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Figures

Figure 1
Figure 1
Comparison of basal and post-vibroacoustic stimulation fetal heart rate as a function of advancing gestational age.
Figure 2
Figure 2
Comparison of MCA-PSV as a function of advancing gestational age at basal fetal heart rate and post-vibroacoustic stimulation.
See this image and copyright information in PMC

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