OC253: Three‐dimensional power Doppler analysis of cerebral circulation in normal and growth‐restricted fetuses

Abstract

To evaluate the fetal cerebral circulation by using three-dimensional (3D) power Doppler ultrasound in normal and growth-restricted fetuses. In total, 125 singleton pregnancies were studied. One hundred of them were in normal healthy pregnant women with normally grown fetuses between 17 and 40 weeks of gestation. Their data were used to construct normal ranges throughout pregnancy. They were compared with the other 25 pregnant women who had fetal growth restriction (FGR) with Doppler-defined placental insufficiency. 3D power Doppler ultrasound and quantitative 3D histogram analyses were used to assess fetal cerebral 3D vascular indices: vascularization index (VI), flow index (FI) and vascularization–flow index (VFI). Both FI and VFI correlated positively with gestational age while VI remained stable throughout pregnancy. All the 3D vascular indices were higher in fetuses with FGR than in the control group. The proportion of fetuses detected as having hemodynamic redistribution was much higher when using 3D power Doppler indices than by means of the MCA-PI (52% vs. 20%; P = 0.002). There were nine cases (36%) of oligohydramnios. While all of them had hemodynamic redistribution according to the 3D power Doppler indices, only five cases were diagnosed with this according to MCA-PI measurements (P = 0.04). Cerebral blood flow increases with gestation. All the fetal cerebral 3D vascular indices are increased in fetuses with FGR and they are more sensitive than MCA measurements in detecting fetal hemodynamic redistribution.