Name of the Procedure:

Doppler Velocimetry, Fetal; Middle Cerebral Artery
Common name(s): Fetal MCA Doppler, Middle Cerebral Artery Doppler, Doppler Ultrasound of Fetal Brain

Summary

A Doppler Velocimetry of the fetal middle cerebral artery is a non-invasive ultrasound test that measures the blood flow in the middle cerebral artery of a developing baby. This procedure helps assess the baby's health, particularly in relation to oxygenation and blood circulation.

Purpose

This procedure is particularly used to:

• Monitor and detect fetal anemia.
• Assess fetal well-being in cases of intrauterine growth restriction (IUGR).
• Evaluate the risk of hypoxia (low oxygen levels) in the fetus.
• Make informed decisions regarding the timing of delivery in high-risk pregnancies.

Indications

• Suspected or confirmed fetal anemia.
• Intrauterine growth restriction (IUGR).
• Fetal infections, such as Parvovirus B19.
• Twin-to-twin transfusion syndrome (TTTS) in multiple pregnancies.
• Abnormal results from other fetal assessments or maternal conditions (e.g., preeclampsia, autoimmune diseases).

Preparation

• No specific preparation is typically required.
• The patient might be advised to have a full bladder to optimize ultrasound images.
• Inform the healthcare provider of any medications being taken.

Procedure Description

1. Patient Positioning: The patient lies on their back on an examination table.
2. Ultrasound Gel Application: A conductive gel is applied to the abdomen.
3. Ultrasound Probe Use: A transducer (ultrasound probe) is placed on the gel-covered abdomen.
4. Image Capture: The healthcare provider moves the transducer to locate the fetal head and specifically the middle cerebral artery.
5. Doppler Assessment: Doppler velocimetry is used to measure the velocity of blood flow in the artery.
6. Data Interpretation: The velocity measurements are interpreted to assess fetal wellbeing.

Tools and equipment: Ultrasound machine with Doppler capability, conductive gel.
No anesthesia or sedation is required.

Duration

The entire procedure typically takes about 20-30 minutes.

Setting

Performed in a hospital's ultrasound department or a specialized outpatient clinic.

Personnel

• Obstetrician or Maternal-Fetal Medicine Specialist
• Ultrasound Technician or Sonographer

Risks and Complications

The procedure is generally safe with minimal risks. Rarely, there might be slight discomfort from the pressure of the transducer on the abdomen.

Benefits

• Provides critical information about the fetus’s blood flow and oxygenation.
• Helps in the early detection of serious conditions like fetal anemia.
• Assists in making decisions about interventions, potentially improving outcomes for the fetus.

Recovery

• No recovery time needed.
• The patient can resume normal activities immediately after the procedure.
• Results will be discussed with the healthcare provider, and any necessary follow-up appointments will be scheduled.

Alternatives

• Other fetal monitoring techniques like cardiotocography (CTG) or biophysical profile (BPP).
• Amniocentesis, which is more invasive, for diagnosing fetal anemia.
• Pros: Non-invasive, relatively quick, and provides immediate information.
• Cons: May not provide as detailed information as invasive diagnostic tests.

Patient Experience

• During: The patient will feel the cool gel on the abdomen and gentle movements of the transducer.
• After: There may be slight residual gel on the skin, which can be easily cleaned off.
• Pain management and comfort: The procedure is generally comfortable, with no pain expected.