US Doppler and Power Doppler Prediction of Recurrent Fetal Growth Restriction. Prospective Cohort Study

Abstract

Background: Intrauterine growth restriction(IUGR) has been defined as the rate of fetal growth that is below normal in light of the growth potential of a specific infant as per the race and gender of the fetus. A woman with a prior pregnancy complicated by IUGR has nearly a 20% risk of recurrence. Defects in placental vascular development can cause embryonic death, can negatively affect fetal growth and can confer a higher risk of disease in the postnatal life. Objective: study aimed to assess the role of first trimester uterine artery Doppler pulsatility index, placental volume and placental vascularization assessed in prediction of recurrence of third trimester intrauterine growth restriction. Methods: In this Prospective longitudinal observational study,two hundred pregnant women with singleton pregnancy from 11 up to 13 weeks with history of intrauterine growth restriction in a previous pregnancy underwent ultrasound assessment of gestational age, ultrasound assessment of uterine artery pulsatility index, placental volume by 3D ultrasound and placental vascularization by 3D power Doppler (3DPD). Results: Placental volume, vascularization index, flow index(F.I), vascularization flow index, and Uterine artery pulsatility index were significantly lower in IUGR with PET(pre eclampatic toxemia) group and IUGRgroup versus normal group, (p-value<0.001).Further, placental volume and F.I were significantly lower in IUGR and PET group compared to IUGR only group. Conclusions: The 1st trimester placental volume, uterine artery Doppler, and, placental vascular indices are useful parameters for prediction of recurrence of IUGR.