Role of Colour Doppler in the Prediction of Perinatal Outcome in Intrauterine Growth Restrictions

Abstract

Analyzing umbilical artery, middle cerebral artery, and uterine artery by Doppler Velocimetry in intrauterine growth restricted foetuses, in order to predict adverse peri-natal outcomes and also the clinical management of such pregnancies. A prospective study with 60 ante-natal women in their third trimester was included in the study and was subjected to colour Doppler examination. Findings of Doppler studies were used to evaluate foetal well-being and were correlated with perinatal outcome. Out of 60 foetuses, 38 had at least one unfavourable perinatal outcome, including six intrauterine deaths, admission of 12 neonates to NICU, low APGAR score in 14 neonates, and emergency caesarian delivery of 18 babies. A single cut off value (1.08) for the ratio of middle cerebral artery and umbilical artery pulsatility index was used and the value above 1.08 was considered normal and below it is abnormal. The value of cerebro-umbilical ratio revealed that 63.3% of foetuses had redistribution of blood to the brain. The present study showed that in women with intrauterine growth restricted foetuses colour Doppler ultrasound is a useful tool to evaluate the neonatal outcomes. The cerebro-umbilical ratio was a better predictor for foetal outcome in terms of sensitivity and predictive value. Moreover, the absent/reversal of end diastolic flow in umbilical artery represents altered blood flow and indicates the risk of chronic hypoxia in foetus leading to high mortality.