Colour Doppler Evaluation of Cerebro-Placental Ratio and it’s outcome in Intra Uterine Growth.

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Colour Doppler Evaluation of Cerebro-Placental Ratio and it’s outcome in Intra Uterine Growth.

Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 4

Abstract

Aim: To determine and compare the diagnostic performance of Doppler sonography of maternal uterine arteries, umbilical artery and fetal middle cerebral artery for prediction of adverse perinatal outcome in clinically suspected Intrauterine growth restriction. Material and Methods: Thirty singleton pregnancies beyond 28 weeks of gestation complicated by Intrauterine growth restriction were prospectively examined with Doppler ultrasound of uterine arteries, umbilical artery and middle cerebral artery. Results: Nineteen patients of the thirty included in the study population had at least one adverse outcome, Adverse outcome criteria included perinatal deaths, emergency caesarean section for fetal distress, 5 min APGAR score of less than 7, admission to NICU for complications of low birth weight. Mean birth weight of neonate at delivery was 2.18±0.26 kg (2SD). 70% fetuses had birth weight of less than 2.5kg. There were 3 intrauterine deaths and 27 live births. Of the 3 IUDs two had absent diastolic flow and one had reversal of diastolic flow. The mortality in cases of reversal and absent end diastolic flow was 100% and 40%respectively, indicating grave prognosis. Of 27 live births 6 neonates were admitted to NICU, 7 neonates had 5min APGAR score of less than 7 and 9 babies were born by emergency caesarian section. Conclusion: PI ratio of MCA/Umb A is the most sensitive index in predicting perinatal outcome (89.5%). MCA pulsatility index is the most specific index (90.9%). Sensitivity of uterine artery Doppler to detect utereo-placental insufficiency was 83%. Presence of absent or reversal of diastolic flow in umbilical artery is an ominous sign since it carries a grave prognosis and high mortality. The sensitivity of the Doppler studies can be significantly increased by studying multiple vessels. Hence we conclude that Doppler studies of multiple vessels the uteroplacental and fetoplacental circulation can help in monitoring of compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of delivery in complicated pregnancies.

Authors and Affiliations

Dr. Keerthi Shyam V.

Keywords

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EP ID EP552574
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