Open Access Research article

Nomograms of Iranian fetal middle cerebral artery Doppler waveforms and uniformity of their pattern with other populations' nomograms

Mohammad Kazem Tarzamni1, Nariman Nezami123*, Narges Sobhani1, Nazanin Eshraghi1, Maryam Tarzamni4 and Yashar Talebi1

Author Affiliations

1 Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran

2 Young Researchers Club, Tabriz Islamic Azad University, Tabriz, Iran

3 Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

4 Obstetrics and Gynecology ward, 29 Bahman Hospital, Tabriz, Iran

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BMC Pregnancy and Childbirth 2008, 8:50  doi:10.1186/1471-2393-8-50

Published: 12 November 2008



Doppler flow velocity waveform analysis of fetal vessels is one of the main methods for evaluating fetus health before labor. Doppler waves of middle cerebral artery (MCA) can predict most of the at risk fetuses in high risk pregnancies. In this study, we tried to obtain normal values and their nomograms during pregnancy for Doppler flow velocity indices of MCA in 20 – 40 weeks of normal pregnancies in Iranian population and compare their pattern with other countries' nomograms.


During present descriptive cross-sectional study, 1037 normal pregnant women with 20th–40th week gestational age were underwent MCA Doppler study. All cases were studied by gray scale ultrasonography initially and Doppler of MCA afterward. Resistive Index (RI), Pulsative Index (PI), Systolic/Diastolic ratio (S/D ratio), and Peak Systolic Velocity (PSV) values of MCA were determined for all of the subjects.


Results of present study showed that RI, PI, S/D ratio values of MCA decreased with parabolic pattern and PSV value increased with simple pattern, as gestational age progressed. These changes were statistically significant (P = 0.000 for all of indices) and more characteristic during late weeks of pregnancy.


Values of RI, PI and S/D ratio indices reduced toward the end of pregnancy, but PSV increased. Despite the trivial difference, nomograms of various Doppler indices in present study have similar pattern with other studies.