Role of middle cerebral artery and umbilical artery Doppler velocimetry studies to compare the outcome in post-dated and normal dated pregnancies in a rural population of eastern India

Abstract

Background: Doppler ultrasound velocimetry of umbilical and foetal vessels has become established method of antenatal monitoring, allowing non-invasive assessment of foetal circulation . Aims: To compare role of middle cerebral artery and umbilical artery Doppler velocimetry studies in normal uncomplicated pregnancies and post-dated pregnancies. Materials and Methods: A comparative study was conducted on 130 pregnant women having gestational age of 36 weeks or more who came to the labor ward in reference study period of 1 year in Burdwan Medical College. Study group consists of 65 pregnant women with gestational age of 40-42 weeks while control groups with gestational age of 36-40 weeks. USG Doppler studies were done, APGAR score of neonates were calculated at 1min and 5 min. Comparison of all variables were done using by a software package SPSS 16. Results: No statistically significant difference was noted in Doppler indices (except CPR) in pregnancy with normal and adverse perinatal outcome. 27.6% of mothers of 40-42 weeks had adverse perinatal outcome where as 100% mother of 36-40 weeks’ had normal outcome. Among post-dated pregnancies 48% mothers of 41-42 weeks had adverse perinatal outcome in comparison to 15% at 36-40 weeks of gestation. Only CPR showed significant difference for predicting adverse perinatal outcome (p=0.001). Low CPR (1.34) has high sensitivity and positive predictive value but poor specificity and negative predictive value.   Conclusion: Doppler indices except CPR are not trustworthy. Although CPR cut-off value of 1.335 assures about fetal wellbeing, its low specificity can lead to undue concern and interference.