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The Effect of Fetal Heart Rate on the Peak Systolic Velocity of the Fetal Middle Cerebral Artery: Does Heart Rate Matter?

Citation

Swartz, Anthony E.; Ruma, Michael S.; Kim, Eunhee; Herring, Amy H; .; Menard, M. Kathryn; & Moise, Kenneth J., Jr. (2009). The Effect of Fetal Heart Rate on the Peak Systolic Velocity of the Fetal Middle Cerebral Artery: Does Heart Rate Matter?. Obstetrics & Gynecology, 113(6), 1225-1229. PMCID: PMC3146009

Abstract

OBJECTIVE: To estimate the effect of an increase in the basal heart rate of the fetus on the middle cerebral artery peak systolic velocity (MCA-PSV).
METHODS: This was a prospective longitudinal cohort. Patients between 14 and 36 weeks of gestation were enrolled (N=66). Ultrasound examinations were performed monthly. MCA-PSV measurements were assessed at 0-degree angle of insonation at basal fetal heart rate and after application of vibroacoustic stimulation.
RESULTS: A total of 514 MCA-PSV measurements were obtained in 66 fetuses. No difference in fetal heart rate before and after vibroacoustic stimulation was noted before 27 weeks of gestation. A significant increase in fetal heart rate after vibroacoustic stimulation was detected from a mean+/-standard deviation gestational age of 27.1+/-1.3 weeks onward. A significant decrease in the MCA-PSV was noted between before vibroacoustic stimulation and after vibroacoustic stimulation measurements for examinations 3,4, and 5 (P<.001 for all).
CONCLUSION: Acceleration of the fetal heart rate in the third trimester is associated with a decrease in the middle cerebral artery peak systolic velocity. Assessment of the MCA-PSV for the detection of fetal anemia, particularly in the third trimester, should be undertaken during a period of baseline fetal heart rate to avoid the potential of a false-negative result.
LEVEL OF EVIDENCE: II.

URL

http://dx.doi.org/10.1097/AOG.0b013e3181a4b4b5

Reference Type

Journal Article

Year Published

2009

Journal Title

Obstetrics & Gynecology

Author(s)

Swartz, Anthony E.
Ruma, Michael S.
Kim, Eunhee
Herring, Amy H
.
Menard, M. Kathryn
Moise, Kenneth J., Jr.

PMCID

PMC3146009