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Tips and tricks for performing and interpreting MCA Doppler PSV

fetal Sally Holloway ultrasound

Doppler interrogation of the middle cerebral artery (MCA) to obtain a peak systolic velocity (PSV) is performed to assess fetal anaemia by measuring the velocity of blood flow to the fetal brain. This is because the cerebral vessels respond quickly to the reduction of oxygen levels within the brain. MCA PSV measurement is used only in those pregnancies with a high risk of fetal anaemia such as in cases of maternal alloimmunisation, placental mesenchymal dysplasia and fetal haemorrhage and also in MCDA (monochorionic diamniotic) twins to identify TAPS (twin anaemia polycythemia sequence).

The MCA PSV measurement is a safe way of identifying fetal anaemia and has replaced the more invasive methods of cordocentesis or amniocentesis. This has made it the gold standard for non-invasive testing of fetal anaemia. However, MCA PSV Doppler investigation is not routinely performed by all individuals who participate in obstetric ultrasound. This article aims to provide tips and tricks for obtaining, performing and interpreting the MCA PSV for those starting or already performing these Dopplers.

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