Role of doppler studies in predicting intra – Uterine growth retardation
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 1
Abstract
Introduction: The association between abnormal umbilical artery Doppler velocimetry and adverse pregnancy outcome has been investigated widely. Aims and Objectives: To Study Role of Doppler studies in predicting Intra-Uterine Growth. Retardation Materials and Methods: This was a prospective study done over a period of one and half years in tertiary hospital from August 2012 to February 2014. 100 women with singleton pregnancy attending hospital for OPD were scanned for Doppler velocimetry. Pregnant Patients within 26-30 years were included into study. Data was collected by HP image point colour Doppler machine with convex probe 3.5 MHz with ultrasonography. Fetal biometry and morphology scan was done. The Doppler mode was switched on. These data collected from the study was analyzed using Sensitivity, Specificity, Positive predictive value, Negative predictive value. Result: The majority of the Patients were in the age group of 21-25 Yrs. of age i.e. 51%, followed by 26-30 Yrs. - 32%, ≤20 Yrs. – 13%, and 4% were seen in >31 Yrs. We have found that Out of the 100 women IUGR was found among 8 patients i.e. 8% Notch as a single parameter is best indicator with predictive value i.e. Sensitivity- 42.9%, Specificity- 93.5% however combination of parameter has best sensitivity i.e. Sensitivity 50% Specificity-89.3%. In uterine artery Doppler, when there was notch 38 % patients developed IUGR. This indicates umbilical artery Doppler is associated with abnormal pregnancy outcome, one patient has absent diastolic flow which is associated with IUGR. For the detection of IUGR it was observed that Normal uterine and umbilical artery found in 3.85% individuals; Normal uterine and abnormal umbilical artery found in 12.5% individuals; Abnormal uterine and normal umbilical artery found in 16.67%and Abnormal uterine and umbilical artery found in 100% individuals. Conclusion: Combination of uterine and umbilical artery Doppler is the best indicator for prediction of fetal growth restriction. diastolic notch in the uterine artery as a single parameter is better than the individual Doppler indices in uterine artery. Absent diastolic flow in umbilical artery is better predictor of fetal growth restriction and poor prenatal outcome. Uterine and umbilical artery Doppler may be included in hospital with facilities and infra structure to identify a group of patients at risk of developing fetal growth restriction. As the power of the study is low further studies have to be done to know Doppler predictive value in general population.
Authors and Affiliations
Balaji P Nalwad, Rajesh V Darade, Preshit Chate
Keywords
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