Evaluation of Doppler indices (MCA & UA) and fetal outcomes: a retrospective case-control study in women with hypertensive disorders of pregnancy

Figures & data

Figure 1. (a and b). Best ROC values of fetal distress predicted by the fetal middle cerebral artery resistance index (MCA-RI) and cerebroplacental ratio 3 (CPR-3); (c and d). Best ROC values of small for gestational age (SGA) predicted by MCA-RI and CPR-3. X axis refers to 100%-Specificity%; Y axis refers to Sensitivity%.

Figure 2. Mean and standard deviation were used to describe the fetal middle cerebral artery (MCA) and umbilical artery (UA) blood flow in the three different periods (20–24 weeks, 29–32 weeks and 35-40 weeks. (A). MCA-PI and UA-PI; (B). MCA-RI and UA-RI; (C). MCA-S/D and UA-S/D; (D). MCA-Vm and UA-Vm.

Table 1. The ultrasound detection of the fetal middle cerebral artery, umbilical artery blood flow of the normotensive controls group, GH group and PE/EC group.

Variable	Normotensive controls	GH	PE/EC	P
	(n = 400)	(n = 219)	(n = 181)
20 weeks < GA < 24 weeks
MCA-PI	1.74 ± 0.27	1.71 ± 0.30	1.72 ± 0.28	0.012
MCA-RI	0.81 ± 0.05	0.80 ± 0.05	0.80 ± 0.05	<0.001
MCA-S/D	5.20 ± 1.32	5.12 ± 1.29	5.16 ± 1.35	0.749
MCA-Vm (cm/s)	12.94 ± 2.51	13.02 ± 2.40	12.86 ± 2.54	0.778
UA-PI	1.08 ± 0.15	1.08 ± 0.16	1.09 ± 0.16	0.959
UA-RI	0.67 ± 0.05	0.67 ± 0.06	0.67 ± 0.06	0.917
UA-S/D	3.11 ± 0.51	3.10 ± 0.52	3.15 ± 0.61	0.923
UA-Vm (cm/s)	23.14 ± 5.16	23.32 ± 4.51	22.50 ± 4.85	0.226
CPR-1	1.60 ± 0.31	1.62 ± 0.46	1.61 ± 0.34	0.043
29 weeks < GA < 32 weeks
MCA-PI	1.79 ± 0.31	1.73 ± 0.29	1.74 ± 0.29	<0.001
MCA-RI	0.81 ± 0.05	0.79 ± 0.06	0.80 ± 0.05	<0.001
MCA-S/D	5.65 ± 1.66	5.36 ± 1.60	5.44 ± 1.35	0.095
MCA-Vm (cm/s)	20.06 ± 4.74	20.16 ± 4.61	20.14 ± 5.28	0.777
UA-PI	0.88 ± 0.14	0.88 ± 0.14	0.89 ± 0.15	0.771
UA-RI	0.59 ± 0.06	0.59 ± 0.06	0.60 ± 0.07	0.461
UA-S/D	2.48 ± 0.38	2.49 ± 0.38	2.54 ± 0.44	0.544
UA-Vm (cm/s)	32.17 ± 6.07	32.28 ± 6.22	31.60 ± 6.40	0.432
CPR-2	2.09 ± 0.44	2.01 ± 0.43	2.02 ± 0.44	<0.001
35 weeks < GA < 40 weeks
MCA-PI	1.45 ± 0.27	1.38 ± 0.23	1.39 ± 0.22	0.021
MCA-RI	0.73 ± 0.07	0.72 ± 0.06	0.71 ± 0.05	<0.001
MCA-S/D	4.04 ± 1.11	3.90 ± 1.14	3.95 ± 1.13	0.248
MCA-Vm (cm/s)	28.41 ± 7.61	28.83 ± 7.72	27.03 ± 7.32	0.050
UA-PI	0.78 ± 0.16	0.78 ± 0.15	0.82 ± 0.18	0.022
UA-RI	0.54 ± 0.07	0.54 ± 0.06	0.55 ± 0.08	0.038
UA-S/D	2.22 ± 0.38	2.19 ± 0.30	2.32 ± 0.52	0.041
UA-Vm (cm/s)	37.03 ± 7.61	37.03 ± 7.31	34.80 ± 7.89	<0.001
CPR-3	1.91 ± 0.48	1.82 ± 0.42	1.76 ± 0.46	0.002

GA: gestational age; MCA: middle cerebral artery; UA: umbilical artery; PI: pulsatility index; RI: resistance index; S/D: the ratio of peak systolic blood flow velocity to end-diastolic blood flow velocity; Vm: mean flow velocity.

Table 2. ROC values of fetal distress and small for gestational age predicted by the ultrasound detection of the fetal middle cerebral artery blood flow and CPR.

Variable	AUC	P	95%CI	Youden index	Sen	Spe	Cutoff
Fetal distress (35 weeks < GA < 40 weeks)
MCA-RI	0.740	0.000	0.695–0.786	0.34	0.701	0.643	0.70
CPR-3	0.580	0.026	0.510–0.650	0.19	0.648	0.500	1.65
Small for gestational age
MCA-PI	0.569	0.045	0.503–0.635	0.12	0.500	0.615	1.40
MCA-RI	0.728	0.000	0.683–0.773	0.37	0.524	0.846	0.73
CPR-2	0.648	0.000	0.592–0.704	0.26	0.341	0.923	2.21
CPR-3	0.712	0.000	0.650–0.774	0.30	0.582	0.718	1.77

MCA: middle cerebral artery; PI: pulsatility index; RI: resistance index; S/D: the ratio of peak systolic blood flow velocity to end-diastolic blood flow velocity; CPR: cerebroplacental ratio; CPR-2 refers to the data during GA of 29–32 weeks; CPR-3 refers to the data during GA of 35–40 weeks.