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

J Matern Fetal Neonatal Med. 2022 Dec;35(25):5653-5658. doi: 10.1080/14767058.2021.1888920. Epub 2021 Mar 9.

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.

Keywords: Doppler; middle cerebral artery; pulsatility index; umbilical artery.

MeSH terms

  • Female
  • Fetus / diagnostic imaging
  • Gestational Age
  • Humans
  • Middle Cerebral Artery* / diagnostic imaging
  • Observer Variation
  • Pregnancy
  • Prospective Studies
  • Pulsatile Flow
  • Ultrasonography, Doppler
  • Ultrasonography, Prenatal
  • Umbilical Arteries* / diagnostic imaging