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Cerebellar Doppler velocimetry in the appropriate- and small-for-gestational-age fetus
B Uerpairojkit1, L Chan, A E Reece
1Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut, USA.
Objective:
To compare superior cerebellar artery flow velocity waveforms in the appropriate-for-gestational-age (AGA) and the small-for-gestational-age (SGA) fetus.
Methods:
Superior cerebellar artery velocity waveforms were obtained prospectively from 172 AGA fetuses at 17-41 weeks' gestation. The pulsatility index (PI) was used to quantify the waveforms. Superior cerebellar artery velocity waveforms were also obtained from 30 SGA fetuses divided into group A (n = 15), with a normal umbilical artery PI, and group B (n = 15), with an abnormal umbilical artery PI. The transverse cerebellar diameter was measured in all SGA fetuses.
Results:
The superior cerebellar artery PI was best represented by a second-order polynomial equation [PI = 0.145 + 0.101 x (gestational age) - 0.00197 (gestational age)2]. Small-for-gestational-age fetuses of group A had a superior cerebellar artery PI in the normal range, whereas 13 of 15 fetuses of group B (86.7%) had a PI value less than the individual 95% confidence interval. The transverse cerebellar diameter in group A fetuses was in the normal range in ten of 15 cases, whereas it was in the normal range for all group B fetuses.
Conclusion:
Small-for-gestational-age fetuses with an abnormal umbilical artery PI have "cerebellar-sparing effect," as suggested by a superior cerebellar artery PI less than the normal range and a normal transverse cerebellar diameter.