ISSN: 2454-2342 (online), 2454-2334 (print)
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The New Indian Journal of OBGYN. Epub Ahead of Print

Study of doppler velocimetry in predicting perinatal outcome of clinically suspected intrauterine growth restricted foetuses

Lokeshwari K, Nazmashamim, Sreenivasa B

ABSTRACT

Objectives: To determine and compare the diagnostic performance of doppler sonography of fetal umbilical artery (UA) and middle cerebral artery (MCA) in prediction of adverse perinatal outcome in suspected intrauterine growth retardation (IUGR). Methodology: One hundred singleton pregnancies between 28 and 40 weeks of gestation complicated by intrauterine growth restriction were prospectively examined with doppler ultrasonogrpahy of the UA and MCA and were correlated with fetal outcome. Results: Of the 100 cases, 52 had elevated umbilical systolic/diastolic (S/D) ratio, 58 had elevated umbilical resistance index (RI), 63 had elevated umbilical pulsatality index ( PI). 58 had abnormal MCA S/D, 47 had abnormal MCA RI, 43 had abnormal MCA PI and 57 had cerebroplacental ratio (CPR) <1.08. Birth weight <10th percentile was highest (63.1%) in the abnormal CPR group. LSCS for fetal distress incidence was maximum (30.2%) in the abnormal MCA PI group. 53.4% meconium stained liquor was seen in the elevated umbilical RI group. Maximum perinatal mortality was present in the abnormal MCA PI group (41.8%). NICU stay for >48 hrs was maximum (56.1%) in the CPR<1.08 group. CPR had the highest sensitivity (100%) in predicting more than one adverse perinatal outcome. Conclusion: Doppler studies of multiple vessels in the fetoplacental circulation can help in the monitoring of compromised fetus and can help us predicting neonatal morbidity and mortality. This is helpful in determining the optimal time of delivery in complicated pregnancies.

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