FETAL MIDDLE CEREBRAL-ARTERY BLOOD-FLOW VELOCITIES IN PREGNANCIES COMPLICATED BY INTRAUTERINE GROWTH RESTRICTION AND EXTREME ABNORMALITY INUMBILICAL ARTERY DOPPLER VELOCITY

If they are not delivered in a timely fashion, pregnancies complicated by severe intrauterine growth restriction (IUGR) can lead to fetal lo ss. Conventional fetal well-being tests, including ultrasound measurem ent of fetal growth rate, biophysical profile, nonstress test, and con traction stress test are used to manage these pregnancies. Some fetuse s delivered based on abnormal fetal well-being tests show long-term se quelae. A better understanding of the malfunction of the placenta and its effect on the fetus is desperately required for better management of these cases. We are reporting our experience of 6 such pregnancies followed by fetal middle cerebral artery (MCA) blood flow velocity mea surements. There was significant decrease in MCA flow velocities in al l of these fetuses compared to normal population (p<0.05). Reverting t o normal values occurred prior to the appearance of abnormal conventio nal tests, on average 4 days earlier. In other words, normalization of MCA flow velocities was a harbinger of fetal jeopardy. Although our o bservation includes a small number of patients, there is a potential f or use of MCA blood flow velocity measurement to aid us in understandi ng and managing fetuses with IUGR. This needs to be evaluated in a lar ger study.