Analysis of fetal circulation in umbilical artery and middle cerebral artery studied by Doppler sonography in breech versus cephalic presentation

Abstract

Objectives: An exemplary method for antenatal checking is velocimetry of ultrasonic Doppler utilized to demonstrate fetus and uterine blood vessels. The present study mainly attempts to analyze the fetal circulation in the umbilical artery and middle cerebral artery studied by Doppler sonography in breech versus cephalic presentation. Materials and Methods: To meet the study's aim, a cross-sectional investigation is carried out incorporating eighty-six apparently healthy women with uncomplicated singleton pregnancy at 32-42 weeks of gestation split into two groups based on fetal presentation (breech =33 and cephalic =53). Doppler sonographic studies were performed for both groups for the middle cerebral artery and umbilical artery, the resistive index RI and systolic, diastolic ratio SD were compared among study groups. Meanwhile, some cases were excluded from the study, including multiple pregnancies, pregnant women with chronic systemic diseases and pregnancies with preeclampsia and intrauterine growth restriction, fetal malpresentation other than breech, those with term or preterm labor, and premature rupture of the amniotic membrane. Results: Based on the study's results, there is no notable difference between breech and cephalic groups concerning parity, maternal age, history of abortion, gender, and gestational age. The mean of systolic / diastolic ratio of the umbilical artery was significantly different when comparing fetuses who are presenting with breech (2.33 ± 0.32) vs those with cephalic (2.16 ± 0.34). Conclusion: Fetal presentation whether breech or cephalic showed no remarkable effect on some Doppler indices of the umbilical and middle cerebral arteries except for the mean of systolic / diastolic ratio of umbilical arteries was clearly higher among breech presenting fetuses