Intra-observer variability of Doppler measurements in umbilical artery (UA) and middle cerebral artery (MCA) in uncomplicated term pregnancies

Abstract

Objective To evaluate the intra-observer variability of the middle cerebral artery (MCA) and umbilical artery (UA) Doppler measurement taken under optimal conditions in term, uncomplicated pregnancies. Methods A prospective study on uncomplicated singleton term pregnancies was performed. Multiple Doppler measurements were taken in the MCA and the UA by one examiner. Intra-rater agreement was calculated. Doppler indices were correlated to fetal biometric parameters and to gestational age. Results One hundred patients were recruited. MCA indices were found to have the highest strength of intra-rater/observer agreement (K = 0.888) versus only a “good” agreement for UA pulsatility index (PI) (K = 0.755).The MCA-PI was significantly correlated with BPD (r = −0.198, p = .047), EFW (r = −0.241, p = .01) and birthweight (r = −0.208, p = .03). A statistically significant decrease was found in the MCA PI (r = −.422, p < .001) and in the CPR (r = −0.444, p < .001) with advancing pregnancy, between 37 and 42 weeks gestation. The UA PI did not change significantly (p = .099) during this period. Conclusions MCA PI measured at term is reproducible with a high ICC. MCA PI significantly decreases with advancing gestation at term. No correlation was found between Doppler measurements and time to delivery.