Assessment of Fetus Middle Cerebral Artery in Hypertensive Pregnant Mothers Using Ultrasonography

Abstract

This is a scientific and practical study which was done during June 2015 to October 2015 and was carried out in United Arab Emirates (Abu Dhabi, Gulf hospital and Elqadi medical center). The study discusses the assessment of fetus middle cerebral Artery in hypertensive pregnant women using ultrasounograpy. A total of “82” singleton pregnancy; divided to tow groups, 42 represent the control group and 40 the target group referred by physician for fetal growth scan. Any singleton or multiple pregnancies with major malformation or chromosomal abnormality and other maternal pathology than hypertension were excluded. All patients were subjected to be examined by U/S scanning using (iU22 ultrasound system. Philips) and (VolusonE6, GE health care, USA) of C5 to 1 MHz curvilinear transducer. Routine obstetric ultrasonography was done for each subject using 2D mode to evaluate the fetal growth. by the way UA Doppler measurements examined in segment of free floating of the cord and detect the flow velocity in vertical plane allows the pulsed Doppler gate to be placed with a minimum angle of insonation .Then Doppler measurements for MCA flow velocity were obtained on the transverse plane, by magnifying the circle of Willies and the MCA for at least 50% of the screen. Data collected by clinical sheet for each patient in the two groups and finally tabulated in two separate sheets one for normal maternal and other for hypertensive maternal. The clinical history of last three reading of BP and protein in urine for hypertensive mothers had been taken. The software Microsoft office Excel 2010 was utilized for data organization. The cases were divided into six gestational age groups by three week intervals. Analyses were conducted using the social sciences Statistical web site by using simple descriptive statistics such as mean, median and stander deviation for measurable features, quantitative-percentage Structures for qualitative features and calculator statistics using significant tests like Analysis of samples as dependent samples using Wilcoxon signed-rank test and analysis of samples as independent samples using Mann– Whitney U test was done. Significance was accepted at P<0.01. Also the correlation between variables and GA using Pearson’s correlation test. X This study found that in control group the relation between MCA PI values and GA show gradually increase in PI values in early term and sudden decrease in midterm between 30-32 weeks and again increase in late term(mean PI 2.13) which was approved in previous studies with completely inversed relation in target group (mean PI 1.47). The study showed that in control group the relation between the MCA width and GA show increment in late of term between 36-38 weeks and less value in the remained term (mean width 0.39cm) .with irregular values within the all term in target group(mean width 0.49cm). In control group the relation between the MCA PI/UAPI ratio shows gradually increase in CPR values in early term and sudden decrease in midterm between 30-32 weeks and again increase in late term (mean CPR 2.31) which was approved in previous studies with irregular general decreases in CPR values in all gestational age rang groups in target group (mean CPR 1.13). The association between the MCA PI, MCA width and GA showed negative correlation between PI and GA with (r=-0.369). And positive correlation between width and GA with (r=0.282). The p value from r score result in insignificant difference between the two variables and GA. (p=0.101, 0.216 respectively). This study recommended that any hypertensive pregnant woman should be scanned by U/S routinely to rule out any abnormality in MCA diameter and PI to save fetus from serious complication.