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Role of Colour Doppler Indices in the Diagnosis of Intrauterine Growth Retardation in High-Risk Pregnancies

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Abstract

Purpose

Intra uterine growth retardation (IUGR) due to fetoplacental vascular insufficiency is rampant in developing countries like India. Owing to the lack of awareness, antenatal patients often present in their third trimester for their first ultrasound examination. Alterations in the waveforms and Doppler indices of fetal middle cerebral artery (MCA), umbilical artery and bilateral uterine arteries have been extensively described in various studies in the literature. However, the role of each doppler parameter in actually predicting reduced birth weight (for gestational age) in the third trimester is often debatable and frustrating.

Method

A prospective study was done on 100 patients of clinically suspected IUGR/high-risk pregnancies of 31–41 weeks. The cases were followed till delivery; the doppler and grey scale findings were correlated with the birth weight of the baby.

Result

The highest sensitivity was found to be of HC/AC ratio, (84.4 %), the highest specificity of oligohydramnios and Cerebral/Umbilical Pulsatility ratio[C/U ratio] (100 %). The sensitivity of C/U ratio was found to be 68.8 %. Fetal MCA had the lowest sensitivity (7.7 %).

Conclusion

HC/AC ratio is quite sensitive, and oligohydramnios is a highly specific parameter to diagnose IUGR. However, the former has lower specificity, and the latter has very poor sensitivity. The MCA PI alone is not sensitive at all, and should not be used for screening purposes in IUGR patients. Also, C/U ratio is more sensitive than oligohydramnios and more specific than HC/AC ratio and stands out as the best parameter of all to diagnose IUGR in the third trimester.

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References

  1. Kurjak A, Kirkinen P, Latin V. Biometric and dynamic ultrasound assessment of small for dates infants. Obstet Gynaecol. 1980;56(3):281–4.

    CAS  Google Scholar 

  2. Manning FA, Platt LD, Sipos L. Antepartum foetal evaluation: development of a biophysical profile. Am J Obst Gynecol. 1980;136(6):787–95.

    CAS  Google Scholar 

  3. Philipson EH, Sokol RJ, Williams T. Oligohydramnios: clinical association and predictive value for IUGR. Am J Obst Gynecol. 1983;146(3):271–8.

    CAS  Google Scholar 

  4. Laurin J, Persson PH. Ultrasound screening for detection of IUGR. Acta Obst Gynecol Scand. 1987;66(6):493–500.

    Article  CAS  Google Scholar 

  5. Tannirandorn Y, Phaosavasdi S. Significance of an absent or reversed end-diastolic flow velocity in Doppler umbilical artery waveforms. J Med Assoc Thai. 1994 Feb;77(2):81–6.

  6. Yoshimura S, Masuzaki H, Gotoh H, et al. The relationship between blood flow redistribution in umbilical artery and middle cerebral artery and fetal growth in intrauterine growth retardation. Nihon Sanka Fujinka Gakkai Zasshi. 1995;47(12):1352–8.

    PubMed  CAS  Google Scholar 

  7. Banu AA. Doppler velocimetry in the umbilical and middle cerebral arteries in fetuses with intrauterine growth retardation or fetal distress. Fukoka Igaku Zasshi. 1998;99(5):133–44.

    Google Scholar 

  8. Bano S, Chaudhary V, Pande S, et al. Color doppler evaluation of cerebral-umbilical pulsatility ratio and its usefulness in the diagnosis of intrauterine growth retardation and prediction of adverse perinatal outcome. Indian J Radiol Imaging. 2010;20(1):20–5.

    Article  PubMed  Google Scholar 

  9. Jurisić A, Jurisić Z, Pazin V, et al. Fetal cerebral-umbilical Doppler ratio in prediction of fetal distress in patients with preeclampsia. Vojnosanit Pregl. 2010;67(6):487–92.

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiodiagnosis and Imaging, Gandhi Medical College, Bhopal, Madhya Pradesh, India

    Rajesh Malik (Professor and Head of the Department) & Agamya Saxena (Resident (PG Student)

  2. C-10, Gulmohar Block, Green Meadows, Arera Hills, Bhopal, 462016, India

    Agamya Saxena (Resident (PG Student)

Authors
  1. Rajesh Malik
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  2. Agamya Saxena
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Correspondence to Agamya Saxena.

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Malik, R., Saxena, A. Role of Colour Doppler Indices in the Diagnosis of Intrauterine Growth Retardation in High-Risk Pregnancies. J Obstet Gynecol India 63, 37–44 (2013). https://doi.org/10.1007/s13224-012-0210-4

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  • DOI: https://doi.org/10.1007/s13224-012-0210-4

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