Reference Values for Doppler Parameters of the Fetal Anterior Cerebral Artery throughout Gestation

Abstract

AIM: To construct normal reference values for Doppler parameters in 2 anatomical segments of the fetal anterior cerebral artery (ACA) throughout pregnancy. METHODS: The ACA was evaluated in 373 normally growing fetuses from 20 to 40 weeks of gestation. The first segment of the ACA (ACA-S1) was recorded just after its origin from the internal carotid artery in the same plane as the middle cerebral artery (MCA). The second segment (ACA-S2) was recorded distal to the outlet of the anterior communicating artery. RESULTS: The ACA pulsatility index (PI) behaved similarly in both segments, with a constant increase until 28 weeks followed by a decrease until the end of pregnancy [ACA-S1 PI = 3.49 - 0.37 x gestational age (GA) - (0.0063 x GA(2)), SD = 0.6 - 0.061 x GA - (0.001 x GA(2)); ACA-S2 PI = 1.54 - 0.22 x GA - (0.0037 x GA(2)), SD = 0.206 + (0.0037 x GA)]. Peak systolic velocities in both segments showed a constant increase from 20 to 40 weeks of gestation. No significant differences were found between the 2 segments with regard to any Doppler parameter. However, the angle of insonation and the time spent on examination were significantly lower and reproducibility was better for ACA-S1. CONCLUSION: Despite showing similar Doppler values, ACA-S1 has a higher reliability than ACA-S2 and can be recorded in the same anatomical projection as the MCA.