The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
-
Rodney McLaren
,
Bharati Kalgi
Abstract
Objective
The aim of this study was to compare position-related changes in fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).
Methods
A prospective study of 41 women with conditions associated with placental-pathology (chronic hypertension, pregestational diabetes, and abnormal analytes) and 34 women without those conditions was carried out. Fetal MCA Doppler velocity flow waveforms were obtained in maternal supine and left lateral decubitus positions. MCA PI Δ was calculated by subtracting the PI in the supine position from the PI in the left lateral position. Secondary outcomes included a composite of adverse perinatal outcomes (fetal growth restriction, oligohydramnios, and preeclampsia). χ2 and Student t-tests and repeated-measures analysis of variance were used.
Results
MCA PI Δ was significantly less for high-risk pregnant women ([P = 0.03]: high risk, left lateral PI, 1.90 ± 0.45 vs. supine PI, 1.88 ± 0.46 [Δ = 0.02]; low risk, left lateral PI, 1.90 ± 0.525 vs. supine PI, 1.68 ± 0.40 [Δ = 0.22]). MCA PI Δ was not significantly different between women who had a composite adverse outcome and women who did not have a composite adverse outcome (P = 0.843).
Conclusion
Our preliminary study highlights differences in position-related changes in fetal MCA PI between high-risk and low-risk pregnancies. These differences could reflect an attenuated ability of women with certain risk factors to respond to physiologic stress.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: None declared.
References
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Article note:
Presented as a poster presentation at American Congress of Obstetricians and Gynecologists District II, New York, NY, October 22, 2016, New York Obstetrical Society, New York, NY, April 4, 2017, and American Congress of Obstetricians and Gynecologists Annual Clinical and Scientific Meeting, Nashville, TN, May 5, 2019.
©2020 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Editorial
- Women and children first: the need for ringfencing during the COVID-19 pandemic
- Review
- The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
- Original Articles – Obstetrics
- Fetal renal artery impedance in pregnancies affected by preeclampsia
- The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
- Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
- Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
- How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
- Disorders of placental villous maturation in fetal death
- Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
- Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
- Original Articles – Fetus
- Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
- Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
- Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
- Original Articles – Newborns
- Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
- The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
- Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
