Abstract
Abstract
Purpose: Middle artery peak systolic velocity (MCA-PSV) is routinely monitored after radiofrequency ablation (RFA) for fetal reduction. This study aimed to investigate the relationship between dynamic MCA-PSV changes and pregnancy outcomes following RFA.
Method: This retrospective study enrolled 63 patients who underwent RFA for fetal reduction. MCA-PSV measurements were systematically recorded at 1 day, 1 week, and 1 month postoperatively. The associations between abnormal MCA-PSV values and fetal brain injury detected by MRI at 3–4 weeks post-surgery, as well as intrauterine fetal demise within 2 weeks post-surgery, were analyzed.
Results: Among the 63 enrolled patients, MCA-PSV measurements were evaluable in 60 cases. Abnormal MCA-PSV values at any of the three time points were observed in 12 of the 60 patients (20.0%), including 10 cases of transient abnormalities and 2 cases of persistent abnormalities. Postoperative MRI was completed in 54 patients, and fetal brain injury was identified in 4 cases. The sensitivity, specificity, positive predictive value, and negative predictive value of MCA-PSV abnormality for predicting MRI‑detected brain injury were 0.0%, 78.0%, 0.0%, and 90.7%, respectively.
Conclusion: In this study, the abnormal MCA-PSV after RFA was mostly a transient change, with limited independent predictive value for MRI-confirmed brain injury. Clinical decision-making should be based on MRI and comprehensive clinical evaluation, rather than solely relying on MCA-PSV results.