The New Indian Journal of OBGYN. 12(1):202-206

Role of fetal biometry and color Doppler indices in pregnancies with early onset fetal growth restriction in a tertiary care hospital

Asha Choudhary, Jyotsna Vyas, Sunita Kumari, Chelsae Kuntal

ABSTRACT

Background: Fetal growth restriction, FGR is a leading cause of stillbirth, neonatal mortality, and short-term and long-term neonatal morbidity. The most recent consensus based definition for defining early and late FGR is through Delphi procedure. Objectives: In this study we assessed the role of fetal biometry and colour Doppler indices for detection and surveillance early onset fetal growth restriction, so as to identify fetuses most at risk and manage these pregnancies to improve the perinatal outcome. Methods: It was a prospective, non-invasive, descriptive study of 60 pregnant females presenting with gestational age of 22+0 wks to 31 wks + 6 days complicated with early onset fetal growth restriction. Written informed consent was taken. After thorough history and examination, they underwent ultrasonography for fetal biometry and colour Doppler to confirm clinical diagnosis. They were followed till pregnancy was terminated and their fetomaternal outcomes were analyzed. Results: In the study, 41.67% cases were primigravida, with mean age of 26.98 ± 4.83 years. 65% of cases were associated with pre-eclampsia. On fetal biometry it was found that, 83.33% of cases had EFW / AC less than 3rd percentile and 16.67% cases had EFW / AC between 3rd percentile to 10 percentile. On ultrasound Doppler assessment, 10% cases were with normal Doppler. Maximum 61.66% cases had abnormal umbilical artery Doppler and 28.33% had abnormal uterine artery Doppler at the time of diagnosis. During surveillance 35% cases developed brain sparing effect, 36.66% patients had CPR <1 and 8.33% cases had abnormal ductus venosus Doppler. 55% of deliveries were terminated for fetal indication, majority 38.33% were for pathological Doppler (AEDF /REDF). Mean gestation age at delivery was 32.73 ± 2.90 weeks. Caesarean section was done in 81.67% women In our study, 2 fetuses out of 60 had intrauterine death, 6 were stillbirth and rest were live birth. Mean birth weight was 1349 ± 416.81 gms. 53.33% fetuses had Apgar score <7. 41.66% fetuses were admitted to NICU and 4 neonatal mortality happened during study period. Conclusion : Fetal biometry and colour Doppler has got significant role in improving perinatal morbidity and mortality in pregnancies with early onset fetal growth restriction.