Strand KM, Torp H, Husby AE, Salvesen KÅB, Nyrnes SA. Continuous fetal cerebral blood flow monitoring during labor: A feasibility study.
Early Hum Dev 2023;
182:105791. [PMID:
37267889 DOI:
10.1016/j.earlhumdev.2023.105791]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND
Current methods for fetal surveillance during labor have significant limitations. Since continuous fetal cerebral blood flow velocity (CBFV) monitoring during labor may add valuable information about fetal well-being, we developed a new ultrasound system called VisiBeam. VisiBeam consists of a flat probe (diameter 11 mm) with a cylindric plane wave beam, a vacuum attachment (diameter 40 mm), a scanner, and a display.
AIMS
To assess the feasibility of VisiBeam for continuous fetal CBFV monitoring during labor, and to study changes in CBFV during uterine contractions.
STUDY DESIGN
Descriptive observational study.
SUBJECTS
Twenty-five healthy women in labor with a singleton fetus in cephalic presentation at term. A transducer was placed over a fontanelle and attached to the fetal head with vacuum suction.
OUTCOME MEASURES
Achievement of continuous good quality fetal CBFV measures, such as peak systolic velocity, time averaged maximum velocity and end diastolic velocity. Trend plots of velocity measures display changes in CBFV between and during uterine contractions.
RESULTS
Good quality recordings during and between contractions were achieved in 16/25 fetuses. In twelve fetuses, CBFV measures were stable during uterine contractions. Four fetuses showed patterns of reduced CBFV velocity measures during contractions.
CONCLUSIONS
Continuous fetal CBFV monitoring by VisiBeam was feasible in 64 % of the subjects during labor. The system displayed variations of fetal CBFV not available by today's monitoring techniques and motivates for further studies. However, improvement of the probe attachment is required to ensure good quality signal in a higher proportion of fetuses during labor.
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