COMPARISON OF PERINATAL OUTCOME IN GROWTH RESTRICTED FETUSES RETAINING NORMAL UMBILICAL ARTERY DOPPLER FLOW TO THOSE WITH DIMINISHED END-DIASTOLIC FLOW

Tariq Saeed Siddiqui, Aisha Asim, Shafqut Ali, Tahir Saeed Siddiqui, Asima Tariq

Abstract


Background Intrauterine growth restriction /retardation (IUGR) is defined as birth weight below the 10th percentile for a given gestational age. Placental insufficiency is the primary cause of intrauterine growth retardation in normally formed fetuses and can be identified using umbilical artery Doppler velocimetry which is a non-invasive technique. The objective of this study was to compare perinatal outcome in growth restricted fetuses retaining normal umbilical artery doppler flow to those with diminished or severely reduced/absent end-diastolic flow. Methods: This cross sectional study was conducted at Radiology department of Pakistan Navy Ship (PNS) Shifa Hospital, Karachi over one year period from. Established cases of asymmetrical IUGR, having estimated fetal weight <10th percentile for gestational age and between 28–40 weeks of gestation were included in the study. Pulsatility index (PI) was calculated for each case. Perinatal outcomes like early delivery, caesarean section, respiratory distress syndrome, necrotizing enterocolitis, admission to neonatal ICU, prenatal and neonatal death were evaluated. Chi-square test was used to compare proportion difference of perinatal outcomes for normal and abnormal umbilical artery velocimetry, with 0.05 level of significance. Results: Umbilical artery doppler velocimetry showed a significant correlation with the perinatal outcome. In 90% of cases of IUGR having abnormal waveform, poor perinatal outcome was seen as compared to only 33.3% retaining normal doppler flow. Conclusion: Growth restricted fetuses with normal umbilical artery doppler velocimetry were at lower risk than those with abnormal waveforms.

Keywords: Umbilical artery Doppler; Intrauterine growth restriction; Perinatal outcome

Full Text:

PDF

References


Rana MJ, Amanullah A, Farooq O. The role of umbilical artery Doppler in detection and management of fetal growth retardation. Biomedica 2005;21:4–7.

Gagnon R, Van den Hof M .The use of fetal Doppler in obstetrics. J Obstet Gynaecol Can 2003;25:601–14.

Mikovic Z , Mandic V, Djukic M, Egic A, Filimonovic D, Cerovic N, et al. Longitudinal analysis of arterial Doppler parameters in growth retarded fetuses. Srp Arh Celok Lek 2003;131:21–5.

Bhatt CJ, Arora J, Shah MS. Role of color Doppler in pregnancy induced hypertension (a study of 100 cases). Indian J Radiol Imaging 2003;13:417–20.

Soregaroli M , Bonera R ,Danti L, Dinolfo D, Taddei F, Valcamonica A, et al. Prognostic role of umbilical artery Doppler velocimetry in growth-restricted fetuses . J Matern Fetal Neonatal Med 2002;11:199–203.

Rowlands DJ, Dubbins PA. Clinical applications of Doppler ultrasound in obstetrics. In: Allan PA, Dubbins PA, Poznaik MA, McDickens WN, editors. Clinical Doppler ultrasound. 2nd ed. Edinburg: Churchill Livingstone; 2005.p. 256–76.

Shamim A, Khan H, Rana J, Ahmed K. Intrauterine growth restriction: a perspective for Pakistan. J Pak Med Assoc 1999;49(2):50–2.

Shand AW, Hornbuckle J, Nathan E, Dickinson JE, French NP. Small for gestational age preterm infants and relationship of abnormal umbilical artery Doppler blood flow to perinatal mortality and neurodevelopmental outcomes. Aust NZ J Obstet Gynaecol 2009;49:52–8.

Ghosh GS, Gudmundsson S. Uterine and umbilical artery Doppler are comparable in predicting perinatal outcome of growth-restricted fetuses. BJOG 2009;116:424–30.

McCowan LM, Harding JE, Stewart AW. Umbilical artery Doppler studies in small for gestational age babies reflect disease severity. BJOG 2000;107:916–25.

Baschat AA, Cosmi E, Bilardo CM, Wolf H, Berg C, Rigano S, et al. Predictors of neonatal outcome in early-onset placental dysfunction. Obstet Gynecol 2007;109:253–61.

Vergani P, Roncaglia N, Locatelli A, Andreotti C, Crippa I, Pezzullo JC, et al. Antenatal predictors of neonatal outcome in fetal growth restriction with absent end-diastolic flow in the umbilical artery. Am J Obstet Gynecol 2005;193:1213–8.

Cosmi E, Ambrosini G, D'Antona D, Saccardi C, Mari G. Doppler, Cardiotocography, and Biophysical Profile Changes in Growth-Restricted Fetuses. Obstet Gynecol 2005;106:1240–5.

Yildirim G, Turhan E, Aslan H, Gungorduk K, Aslan H Guven H, Idem O, et al. Perinatal and neonatal outcomes of growth restricted fetuses with positive end diastolic and absent or reversed umbilical artery Doppler waveforms. Saudi Med J 2008;29:403–8.

Rizvi SMR, Yasmeen N, Iqbal N. Small for gestational age fetus; role of colour Doppler ultrasound in the management. Professional Med J 2006;13:705–9.


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]