Fetal middle cerebral artery pulsatility index
Dr Yuranga Weerakkody ◉ et al.
The fetal middle cerebral artery (MCA) pulsatility index (PI) is a key parameter used in fetal middle cerebral arterial Doppler assessment. It is calculated by subtracting the end diastolic velocity (EDV) from the peak systolic velocity (PSV) and then dividing by the time averaged (mean) velocity (TAV):
- PI = (PSV - EDV) / TAV
Practical points
The fetal MCA PI normally has a high value. The mean value (normal reference range) slowly decreases through gestation from around 28 weeks onwards. A low PI reflects redistribution of cardiac output to the brain due to the fetal head sparing theory.
See also
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Ultrasound - obstetric
- ultrasound (introduction)
- obstetric ultrasound
- first trimester and early pregnancy
- ectopic pregnancy
- multiple gestations
- subchorionic hematoma
- failed early pregnancy
-
second trimester
- fetal biometry
- fetal morphology assessment
- fetal echocardiography views
- nonvisualisation of the fetal stomach
-
soft markers
- nuchal fold thickness
- ventriculomegaly
- absent nasal bone
- choroid plexus cysts
- enlarged cisterna magna
- shortened fetal long bones
- echogenic intracardiac focus (EIF)
- echogenic fetal bowel
- aberrant right sublavian artery
- fetal pyelectasis / fetal renal pelvic dilatation
- single umbilical artery
- sandal gap toes
- amnioreduction
- Doppler ultrasound
- nuchal translucency
- 11-13 weeks antenatal scan
- chorionic villus sampling (CVS) and amniocentesis
- placenta
- other
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