Role of Color Doppler Flowmetry in Prediction of Intrauterine Growth Retardation in High-Risk Pregnancy

Khanduri, Sachin; Chhabra, S; Yadav, Santosh Kumar; Sabharwal, Tushar; Chaudhary, Mriganki; Usmani, Tarim; Goyal, Arun; Sharma, Hritik

doi:10.7759/cureus.1827

Cited by 18 publications

(20 citation statements)

References 24 publications

(29 reference statements)

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“…Delivery was indicated according to standard obstetric practice guidelines at Obstetrics and Gynecology Department, Al-Azhar University new Damietta Hospital. Delivery had been indicated in the following circumstances [1] When there were an evidence of absent or reversed a-wave in the DV or decelerative cardiotocography, then delivery was indicated after 28 weeks of gestation; [2] Delivery was recommended in case of umbilical artery reversed end diastolic flow [REDF] between 30 and 32 weeks; [3] Delivery was recommended in case of umbilical artery absent end diastolic flow [AEDF] between 32 and 34 weeks; and [4] Delivery was recommended in case of umbilical artery PI >95 th centile beyond [34 weeks].…”

Section: Sonographic Data Included Abdominal Circumference [Ac]mentioning

confidence: 99%

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The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Bellehy

Omar

Eid

et al. 2020

International Journal of Medical Arts

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Background: Intrauterine growth restriction [IUGR] represented a challenging health problem, faced during daily clinical practice. Early diagnosis is of crucial importance. Aim of the work: To determine the value of the aortic isthmic flow index and the left mod-myocardial performance index [MPI] in the prediction of adverse perinatal outcomes in fetuses affected by IUGR. Patients and Methods: Forty Singleton fetuses with IUGR between 28 and 34 weeks were recruited. The left mod-MPI and the isthmic flow index [IFI] were calculated. Ultrasound indices had been correlated with perinatal outcome. Results: There was a statistically significant association between abnormal aortic isthmus diastolic flow and low 1-minute Apgar score and neonatal intensive care unit [NICU] admission. There was a statistically significant association between the left mod-MPI and the meconium stained amniotic fluid [AF], the need for Neonatal resuscitation, NICU admission, neonatal sepsis, and neonatal death. When considering cutoff value for prediction of adverse fetal outcome by Left MPI, a cutoff of 0.53 confers 85.2% sensitivity, 80% specificity, PPV 92%, NPV 66.7%, and accuracy of 83.8%. In addition, 85% of fetuses had normal Aortic isthmus [AoI] waveform [IFI type I] and 15% had abnormal AoI waveform, and there was a statistically significant association between abnormal AoI diastolic flow and each of [IFI of II, III, V], [low 1-minute Apgar score] and [NICU admission]. Conclusion: AoI IFI and left mod-MPI could be considered valuable for the assessment of chronic placental insufficiency, and play a role in prediction of adverse perinatal outcome associated with IUGR.

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Section: Sonographic Data Included Abdominal Circumference [Ac]mentioning

confidence: 99%

“…This decision is balanced by risks of prematurity and terminal hypoxemia, if the decision is too late [3] . The timing of delivery is routinely performed on the basis of fetal Doppler [4] . However, the umbilical and middle cerebral arteries Doppler does not necessarily predict the perinatal outcome in growth restricted fetuses [5] .…”

Section: Introductionmentioning

confidence: 99%

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Bellehy

Omar

Eid

et al. 2020

International Journal of Medical Arts

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“…A similar finding was reported by other authors. 8 The percentage of women with antenatal risk factors like PIH, hypertension complicating pregnancy, vascular disorders, maternal infection and delivery of SGA babies in the previous pregnancies were found to be higher in the abnormal ratio group, though it was statistically insignificant. 5,9,10 Similarly when there is IUGR associated with antenatal risk factors, there is more chance of having an abnormal ratio (69% versus 25%) with a p value of 0.002.…”

Section: Discussionmentioning

confidence: 87%

Cerebro-umbilical doppler ratio as a predictor of adverse perinatal outcome

Kamalarani¹,

Victor²

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Intrauterine growth restriction (IUGR) is defined as a subnormal bodyweight or mass in utero. Fetal Doppler studies have been identified as one of the reliable and non-invasive methods of antepartum fetal surveillance in growth-restricted fetuses to detect hypoxemia and to plan timely delivery to precede acidemia. The aim of this study is to evaluate the screening efficacy of the pulsatility indices (PI) of the umbilical artery (UA) and middle cerebral artery (MCA) and the ratio of these two indices in predicting the adverse perinatal outcome in pregnancies complicated by IUGR.Methods: In this study patients were included after diagnosed to have fetal growth restriction clinically by a disparity of four weeks or more between symphysis-fundal height and gestational age and on the serial measurement of symphysis-fundal height after 30 weeks of gestation.Results: Out of 100 patients who fulfilled the criteria for the study, only 85 patients delivered. Out of them, only 16 women (18.8%) had a ratio of <1.08 which was considered abnormal and the rest of the women (81.2%) had a ratio >1.08 which was considered normal. The specificity for the Cerebro-umbilical ratio (<1.08) to predict adverse perinatal outcome was 96% whereas that for PI of umbilical A (>1.12) was 83% and that for the PI of middle cerebral A (<1.2) was 84%. However, the sensitivities for these indices were very low.Conclusions: The ratio of the pulsatility indices of the umbilical artery and middle cerebral artery is useful to predict the adverse perinatal outcome.

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“…These data-collectively-reflected the good predictive power of doppler ultrasound to diagnose preterm birth or IUGR. Khanduri et al [11] had been studied a total of 62 risky pregnancies submitted to measurement of color Doppler indices till delivery and reported an IUGR rate of 30.9%. On all visits [3 visits], the mean values of pulsatility index [PI] and resistance Index [RI] of UA, were significantly increased while MCA PI and RI recordings were significantly reduced in IUGR when compared to non-IUGR patients.…”

Section: Disucssionmentioning

confidence: 99%

Value of Middle Cerebral/Umbilical Artery Resistance Index Ratio in Neonatal Outcome in Patients with Intrauterine Growth Restriction (Prospective Study)

Aziz

Rady

Abdeltawab

2020

International Journal of Medical Arts

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Background: Disorders related to intra-uterine fetal growth usually had different perinatal morbidity and mortality. Accurate diagnosis of intrauterine fetal growth is a challenging difficult task, but recent technological advances are associated with significant improvements with positive impact on antenatal care. Aim of the work: The aim of this study was to evaluate the accuracy of the umbilical and middle cerebral artery Doppler indices [e.g. resistance index] in prediction of fetal outcome in pregnancies with intra-uterine growth restriction (IUGR). Patients and Methods: Forty-five pregnant females had been included in a prospective study. All had a confirmed diagnosis of IUGR. Doppler ultrasound used to record fetal middle cerebral artery [MCA] and umbilical and Doppler indices every one week (from 32 weeks onwards). Post-delivery birth weight, Apgar score at 0 and 5 minutes had been measured and correlated with Doppler indices. Results: One-fifth of the mothers participating in the study (20%) had pre-term birth and 6.7% missed the follow-up. Umbilical artery resistance index (RI) at a cut off value of (0.79) had a diagnostic accuracy of 93%. MCA RI best cut off value was 0.63 with diagnostic accuracy of 73.9%. Also, for C/U ratio had diagnostic accuracy of 92.9%. Finally, there was significant, proportional correlation between MCA RA and C/U ratio from one side and APGAR score at 0 and 5 minutes from the other side. However, the correlation between UARI and Apgar score was inverse and statistically significant. Conclusion: Doppler velocimetry of fetal circulation can provide important information regarding fetal well-being, with subsequent impact on fetal outcome.

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Role of Color Doppler Flowmetry in Prediction of Intrauterine Growth Retardation in High-Risk Pregnancy

Cited by 18 publications

References 24 publications

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

The Prediction of Adverse Perinatal Outcomes in Intrauterine Growth Restriction using the Doppler Indices of Myocardial Performance and Aortic Isthmus

Cerebro-umbilical doppler ratio as a predictor of adverse perinatal outcome

Value of Middle Cerebral/Umbilical Artery Resistance Index Ratio in Neonatal Outcome in Patients with Intrauterine Growth Restriction (Prospective Study)

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