Study of the Significance of Fetal Doppler Flow Velocimetry in the Perinatal Outcome of Growth-restricted Fetuses

Abstract

Purpose: To evaluate clinically suspected cases of intrauterine growth restriction (IUGR) for Doppler study of uterine artery, umbilical artery, and fetal middle cerebral artery. To compare the various indices of the three vessels in predicting perinatal outcome. To evaluate the positive predictive value among these parameters. To compare the Doppler findings with fetal outcome. Materials and methods: One hundred and two singleton pregnancies complicated by IUGR and severe preeclampsia or both were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery, and umbilical vein which were compared with 104 uncomplicated pregnancies that formed the control group. Observation and Results: One hundred and two singleton pregnancies included in the study population had at least one major or minor adverse outcome. Major adverse outcome criteria included perinatal deaths – including intrauterine and early neonatal deaths, etc. Minor outcomes included cesarean delivery for fetal distress, APGAR score below 7 at 5 minutes, and admission to neonatal intensive care unit for treatment. Conclusion: Low diastolic and high indices characterize the pregnancies with abnormal outcomes. The uterine artery had a better sensitivity and specificity as compared with the umbilical arteries and diastolic notch had the highest sensitivity and specificity. Doppler also provides a noninvasive method of assessing the fetal and maternal circulation during pregnancy.