الفهرس 
Doppler UltrasoundOnly 14 pages are availabe for public view
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Abstract
Antenatal care is a primary defense mechanism against diagnosis of the disease and picking up of the severe cases with subsequent early management and intervention. The second line of defense mechanism which would carry the lowest maternal and fetal morbidity and mortality is the aggressive management of severe cases of high risk pregnancy.
Doppler ultrasound:
The use of Doppler ultrasound is not new in obstetric practice. It produces an immense amount of hemodynamic information from a circulation. The use of technique for fetal investigations was first reported 1977.
Doppler signals may be obtained by three types of devices:
1. Continuous wave
2. Pulsed wave
3. Color flow mapping
Methods of analysis:
Doppler blood flow may be analyzed in three ways by:
1. Waveform.
2. Resistance indices.
3. Flow volume or velocity.
The aim of antepartum fetal surveillance is to identify the hypoxic and acidotic fetus and his may prevent intrauterine fetal death and decrease the risk of long-term adverse effects.
Doppler US offers a unique noninvasive technology for investigating the fetal circulatory system. There is ample evidence associating abnormal Doppler findings with complications of pregnancy and an adverse perinatal outcome.
In this study our aim was to evaluate the accuracy of middle cerebral/umbilical artery resistance index (C/U RI) ratio in predicting acidemia and low Apgar score at 5 minutes afterbirth in neonates of high risk pregnant women.
There was a positive significant correlation between Neonatal umbilical cord pH and (MCA/UA) RI ratio and a negative significant correlation between neonatal umbilical cord ~ PH and RI (MCA) and RI (UA).
Also there was a positive significant correlation between Apgar score and (MCA/UA) RI ratio .And a negative significant correlation between Apgar score and RI (UA).But there was no correlation between Apgar score and RI (MCA).
MCA (RI) / UA (RI) was more sensitive and more specific than its two components UA (RI) and MCA (RI) in prediction of neonatal acidosis. Also diagnostic accuracy of MCA (RI)/UARI) was better than diagnostic accuracy of MCA (RI) and UA (RI).
We found that the best cut off value of MCA/UA (RI) ratio for prediction of low cord blood pH, the was 0.87 (sensitivity 85%, specificity 70%), and as predictors of low Apgar score at 5-min, the best cutoff value for MCA-RI/UA-RI ratio was 0.85 (sensitivity 84.6%, specificity 55%), This was more predictive than either the UA-RI or the MCA-RI separately so MCA/UA RI ratio was the best predictor of neonatal outcome, compared with umbilical artery RI and middle cerebral artery RI.
In our study, MCA RI / UA RI ratio was found to be a good predictor of bad neonatal outcome in high risk pregnancies. Also we found that MCA RI / UA RI ratio shows better prediction of neonatal acidemia than its two components (UA RI and MCA RI).