Association between Adverse Outcomes and Middle Cerebral Artery Pulsatility Index Change Based on Maternal Position...

Area of Science:

• Maternal-fetal medicine
• Fetal ultrasonography
• Pregnancy outcomes

Background:

• Maternal position changes influence fetal middle cerebral artery (MCA) Doppler pulsatility indices (PI).
• Previous research suggests MCA Doppler PI changes may predict adverse pregnancy outcomes.

Purpose of the Study:

• To confirm if fetal MCA Doppler PI changes due to maternal position shifts are associated with adverse pregnancy outcomes.
• To investigate the predictive value of a PI change threshold (Δ=0.22) for pregnancy complications.

Main Methods:

• Prospective cohort study of singleton, nonanomalous fetuses (18-24 weeks gestation).
• MCA Doppler PI measured in supine and left lateral maternal positions.
• Cohort divided based on PI change (Δ) ≥0.22 versus <0.22.
• Multivariable logistic regression used to analyze outcomes.

Main Results:

• No significant difference in the composite adverse outcome rate between PI Δ groups.
• Pregnancies with PI Δ ≥0.22 were significantly more likely to develop preeclampsia (aOR: 3.30; 95% CI: 1.02-10.69).
• No differences in fetal growth restriction or oligohydramnios between groups.

Conclusions:

• A second-trimester MCA PI Δ ≥0.22 with maternal position changes is associated with an increased risk of developing preeclampsia.
• This finding suggests a potential link between diminished fetoplacental reserve and preeclampsia.
• No association found between this PI change and other adverse pregnancy outcomes like FGR or oligohydramnios.