Comparative Study of Foetal Outcome in IUGR Pregnancies by Various Parameters of Doppler Flow Velocimetry of Umbilical Artery and Middle Cerebral Artery

Authors

  • Sourabh Kumar Assistant Professor, Naval Hospital, Vishakhapatnam,India
  • Anish Kumar Vishal Associate Professor, Military Hospital Kirkee, Pune,India
  • Dinesh Bhasin Professor, Military Hospital Kirkee, Pune,India
  • Vidhu Dangawal Assistant Professor, Military Hospital Kirkee, Pune,India
  • Shivashish Kumar Medical Officer,IGIMS,Patna,Bihar,India

Keywords:

Intrauterine growth restriction (IUGR), Umbilical artery (UA), Middle cerebral artery (MCA).

Abstract

Background: Intra uterine growth restriction is said to be present in those babies whose birth weight is below the 10th percentile of the average for the gestational age. Approximately 15-20 % babies born worldwide are low birth weight babies and IUGR comprises one third of these low birth babies. Once IUGR is confirmed on USG, further monitoring is done by Doppler velocitometry of Umbilical and middle cerebral artery. The aim of this study was to determine the relationship of various Doppler parameters in predicting adverse fetal outcome in Intrauterine Growth-Restricted (IUGR) pregnancies.Methods: This was a prospective cross-sectional study of 52 clinically IUGR pregnancies on the basis of USG biometry study at 28–40 weeks of gestation. These IUGR pregnancies were followed till delivery. The NICU admission of >48 hrs were taken as adverse perinatal outcome. The various parameters of Doppler velocitometry of umbilical artery (UA) and middle cerebral artery (MCA) such as Systolic–Diastolic Ratio (UA S/D), UA Pulsatility Index (PI), the Middle Cerebral Artery (MCA) PI, Ratio of MCA PI to UA PI and the Ratio of MCA S/D to UA S/D were screened for their sensitivity, specificity, positive and negative predictive values, percentage of true and false negative. Those various parameters of Doppler findings were also compared with the NICU admission/adverse fetal outcome.Results:Doppler velocitometry of umbilical and middle cerebral artery are very effective in monitoring the IUGR pregnancies. Out of various parameters The MCA PI/UA PI ratio had the highest sensitivity of 80 % and specificity of 96.7 % with positive predictive value of 94 and negative predictive value of 88.57 respectively in determining adverse perinatal outcome. In our study PI ratio of Middle Cerebral Artery and Umbilical artery is highly significant for predicting poor perinatal outcome (77.8 %) p value of 0.000 (< 0.01) with Odds Ratio 16.333 (3.954, 67.473) with 95% Confidence Interval.Conclusion: The doppler evaluation of umbilical and middle cerebral artery is very important in monitoring the growth restricted fetus and helps to determine the optimal time for delivery. There were not a single intrauterine fetal demise (IUFD) in the IUGR cases in our study. The PI ratio of Middle Cerebral Artery and Umbilical artery is the most important parameter of doppler evaluation in prdicting adverse perinatal outcome.

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Published

2021-08-16

How to Cite

Sourabh Kumar, Anish Kumar Vishal, Dinesh Bhasin, Vidhu Dangawal, & Shivashish Kumar. (2021). Comparative Study of Foetal Outcome in IUGR Pregnancies by Various Parameters of Doppler Flow Velocimetry of Umbilical Artery and Middle Cerebral Artery. International Journal of Health and Clinical Research, 4(14), 166–171. Retrieved from https://ijhcr.com/index.php/ijhcr/article/view/2311