Reference values of fetal peak systolic blood flow velocity in the middle cerebral artery at 19-40 weeks of gestation

Objectives: The objectives of this prospective study were (i) to establish new reference values of peak systolic blood flow velocity measurement in the fetal middle cerebral artery (MCA-PSV) following validated methodological guidelines and (ii) to develop a method to calculate Z-scores of MCA-PSV. Patients and Methods: Cross-sectional data were obtained from 331 pregnant women between 19 and 40 weeks' gestation. Reference ranges for MCA-PSV were constructed and for each measurement linear regression models were fitted separately to the mean and standard deviations (SD) as a function of gestational age. An application to calculate Z-scores was developed. A comparison was made between the reference ranges produced in our study and those of a previous one. Results: A new chart, table of centiles and regression equations of MCA-PSV are presented. Comparison o four reference ranges with ones produced in a previous study showed similar 5th centile values. However, the values for the 50th and 95th centiles between 19 and 28 gestational weeks were lower in our study. Conclusions: We have constructed reference ranges for MCAPSV which, because they are derived from a larger number of examinations in the 15-20-week period and because the methodological flaws of the previously published study have been eliminated, we consider to be more accurate and therefore more useful for clinical practice.