Diagnosis of Intrauterine Growth Retardation with Color Doppler Evaluation of Cerebral-Umbilical Pulsatility Ratio and Prediction of Adverse Perinatal Outcome
Author(s): Bhanupriya Singh*, Prashant Agrawal, Neha Singh, Gaurav Raj, Rishabh Pratap
Introduction: Growth restriction in fetus is one of the major factors for the complications including NEC, respiratory problems, coronary disease, obesity, hypertension et. Early diagnosis of IUGR fetus can be done using Doppler study of umbilical artery, uterine artery and MCA. Assessment of CPR ia a useful indicator in predicting the outcome of the fetus and helps in the management. Objectives: To evaluate the pulsatility index (PI) of the umbilical artery (UA) and middle cerebral artery (MCA), as well as the ratio of the MCA PI to the UA PI ( C/U RATIO) in the diagnosis of small-for-gestational-age (SGA) fetuses and in the prediction of adverse perinatal outcome. METHODS: The descriptive cross sectional study was conducted over a period of 10 months. All the females who were having clinical suspicion of IUGR were referred to radiology department for fetal biometry and obstetric Doppler between gestational age 30-41 weeks were included in the study. Doppler parameters like PI, RI and CPR was calculated and analyzed to make a diagnosis. Results: Of the 50 pregnancies in the study, 24 showed abnormal UA PI. Among these, 21 were SGA and 19 had adverse perinatal outcome. 6 pregnancies showed abnormal MCA PI, all were SGA and had adverse perinatal outcome. 20 pregnancies showed abnormal C/U ratio, all 20 were SGA and had adverse perinatal outcome. Conclusion: The C/U ratio is a better predictor of SGA fetuses and adverse perinatal outcome than the MCA PI or the UA PI used alone. The UA PI can be used to identify IUGR per se. The MCA PI alone is not a reliable indicator for predicting fetal distress.