Role of doppler velocimetry in determining the prognosis and management of intrauterine growth restricted fetuses
Journal Title: Medpulse International Journal of Gynaecology - Year 2019, Vol 9, Issue 1
Abstract
Objectives: The intrauterine growth retardation (IUGR) takes second position after premature births as a cause for neonate with smaller weight for its gestational age. Perinatal mortality is eight times higher than normal weighted neonates. In India the incidence of low birth weight varies from 15 to 25% and more than 50% of them are IUGR. Methods: The present study was done in department of Radiology between JAN 2018 to DEC 2018. A total of 100 cases of intrauterine growth restricted foetus were studied, Detail history was taken. General and Obstetrical examination was done along with routine haematological and urine investigations. Ultrasound examination was done for growth, AFI (Amniotic fluid Index) and placental localisation. Foetal well being was assessed with doppler study of umbilical artery, uterine artery and Middle cerebral artery. Results: In the present study abnormal colour doppler flow of umbilical, uterine and middle cerebral artery was seen in 82%, 76% and 68% respectively. 22% of foetus with IUGR had normal doppler study. 11% of pregnancies with abnormal doppler flow ended in the form of foetal demise compared to normal doppler flow where foetal demise was only 2.8%. Surgical intervention in the form of caesarean section was require in 76% of pregnancy with abnormal Doppler flow and 48% of pregnancies with normal doppler flow. Cerebro-placental ratio (CPR<1) is associated with 16% foetal demise in contrast to CPR>1 where foetal demise is 2%. Incidence of AEDF/REDF in IUGR was 10% that resulted in 55% loss of foetus. Conclusion: Colour Doppler is a useful mode to predict foetal outcome in IUGR. Colour doppler allows better understanding of hemodynamic changes in feto-placental and uteroplacental circulation. The cerebroplacental ratio (CPR) is now the most powerful parameter for assessment of IUGR and hypoxia.
Authors and Affiliations
Geeta Rani, Sachin Kuimar Singh, Usha Kumari, Anupama Sinha
Keywords
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- EP ID EP470331
- DOI 10.26611/1012915
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