Editor, I read the recent report on middle cerebral artery (MCA) Doppler with a great interest. Nanthakomon et al. concluded that “SGA fetuses with abnormal UA Doppler suffered more morbidity and mortality compared to those with normal UA Doppler. SGA fetuses with normal UA PI but abnormal MCA PI had worse outcomes compared to those with normal UA and MCA PI [Citation1].” I agree that the authors showed the possible clinical usefulness of this Doppler application. The report support the previous finding in USA published by Sterne et al. [Citation2]. However, there are some points to be discussed. First, there should be a good clarification on the control of confounding factor that can result in morbidity and mortality of the cases. Second, a simple question on the reliability of the tool if it is used by different users should be discussed. Inter-observer difference might be expected. Finally, a high false positive of this technique is also the theme for discussion [Citation3].
Declaration of Interest: The authors declare no conflict of interest.
References
- Nanthakomon T, Uerpairojkit B. Outcome of small-for-gestational-age fetuses according to umbilical artery Doppler: is there any yield from additional middle cerebral artery Doppler? J Matern Fetal Neonatal Med 2010;23:900–905.
- Sterne G, Shields LE, Dubinsky TJ. Abnormal fetal cerebral and umbilical Doppler measurements in fetuses with intrauterine growth restriction predicts the severity of perinatal morbidity. J Clin Ultrasound 2001;29:146–151.
- Vergani P, Roncaglia N, Ghidini A, Crippa I, Cameroni I, Orsenigo F, Pezzullo J. Can adverse neonatal outcome be predicted in late preterm or term fetal growth restriction? Ultrasound Obstet Gynecol 2010;36:166–170.