US Doppler Indices in Umbilical and Fetal MCA in Diagnosis of IUGR Fetuses

Background: Intrauterine growth restriction remains a leading contributor to perinatal mortality and morbidity. There is no cure, management is reliant on a structured antenatal surveillance program with timely intervention. Recent advances in ultrasound and Doppler have elucidated several mechanisms of evolution of disease and prediction of threat of intrauterine hypoxia and acidaemia well in advance of other surveillance tests. Materials and methods: This prospective study was conducted in 110 high risk pregnant women attending OPD, admitted in antenatal wards and labor room at Government General Hospital, Siddipet, over a period of 2 years from October-2016 to September 2018; Ultrasound examination was done for interval growth, AFI, placental pathology. Fetal well-being was assessed with Doppler studies of UA and MCA, daily fetal movement count, NST, BPP. Results: In the present study, PIH was found to be the commonest (50.9%) cause of IUGR. Abnormal Doppler Indices in Umbilical and MCA correlated statistically with lower birth weight, higher rates of caesarean delivery, oligohydramnios, lower Apgar scores, perinatal death, and higher admissions to NICU. AEDF/REDF was associated with highest perinatal loss, poor perinatal outcome. Cerebroplacental ratio < 1 (C/U<1) had 100% specificity and 100% PPV. Conclusion: Doppler technology enables a better understanding of the hemodynamic changes in the fetus. It can help in identifying the changes in the fetal circulation well in advance of other surveillance tests, thus identify the truly hypoxic fetus. Interval changes in Doppler indices are useful in determining monitoring frequencies and optional time for delivery.