The Efficacy of Doppler Indices in Third Trimester of IUGR Pregnancies (original) (raw)
Related papers
The Efficacy of Doppler Indices in Third Trimester of IUGR Pregnancies Citation
Gilani. The Efficacy of Doppler Indices in Third Trimester of IUGR Pregnancies. Obstetrics and Gynecology Research 3 (2020): 001-009. Abstract Objective: To identify the usefulness of Doppler indices in the third trimester for intra-uterine growth-restricted pregnancies. Materials and Methods: It was an observational case-control study of singletons with intra-uterine growth restriction (fetal weight <10th percentile). Intra-uterine growth restricted fetuses (cases) and normal (controls) were examined for the umbilical artery. Time intervals between progressive Doppler abnormalities and configurations of worsening were related to umbilical artery Doppler status and gestational age. Gilani Ultrasound Center Lahore Pakistan. A total of 60 pregnant females were studied with normal and abnormal umbilical artery Doppler ultrasound. Results: Doppler indices measurements of umbilical artery in intra-uterine growth restriction fetuses in the third trimester showed higher values as compared to normal fetuses. 30 females had normal umbilical artery Doppler indices and waveforms and 30 females showed (either thinning, absent or reversed Diastolic flow Doppler waveform) with higher indices. Conclusion: Fetal umbilical artery Doppler ultrasound is an effective tool in the detection of early intra-uterine growth restriction fetuses. Obstet Gynecol Res 2020; 3 (1): 001-009
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2004
To evaluate the validity of systolic/diastolic (S/D) ratio of the umbilical artery in predicting intrauterine growth restriction (IUGR). Diagnostic test study. Maharaj Nakorn Chiang Mai Hospital, Chiang Mai University. Two hundred and twelve singleton pregnancies between 30 and 42 weeks' gestation with clinical suspicion of IUGR were recruited and followed-up between December 1st 1995 and June 30th 1998. They were sonographically examined for routine fetal biometry and S/D ratio of umbilical artery Doppler waveform measurement within 14 days of delivery. All of them had an accurate date of last menstrual period and were between 30-42 weeks' gestation. The umbilical artery S/D ratio was obtained by the same experienced sonographer, using the same ultrasound machine, Aloka 680EX, (Tokyo, Japan). The S/D ratio of 3 or greater was considered abnormal, predicting IUGR prenatally for every gestational week. IUGR was defined as low birth weight of less than the 10th percentile of t...
Indian Journal of …, 2006
AIMS: To evaluate the role of umbilical artery Doppler in growth-restricted fetuses. MATERIALS AND METHODS: In a prospective observational study, 70 pregnant women with growth-restricted fetuses confirmed by ultrasound, were followed up with Doppler studies of the umbilical artery. The study group consisted of 35 women, where the Doppler waveform in the umbilical artery was compromised (either absent end diastolic flow [AEDF] or reversed end diastolic flow [REDF]). These were compared with an equal number of controls, where growth-restricted fetuses had normal doppler waveforms. Outcome measures were evaluated in both groups and analyzed. RESULTS: The periods of gestation at delivery were 27.2 ± 3.5 weeks in group 1 and 37 ± 3.3 weeks in-group II, respectively. Perinatal morbidity and mortality was significantly increased in the group with compromised umbilical artery blood group. Birth weight in group I was 742 ± 126 grams and in group II was 1680 ± 259 grams. This difference was statistically significant (P=0.0001). In comparison to AEDF, REDF fetuses had more morbidities. Perinatal mortality was also significantly increased in this group (P=0.001). CONCLUSION: Umbilical artery Doppler should be used in the management of growth-restricted fetuses. In those fetuses in normal Doppler, pregnancy can be prolonged. REDF is an indication for termination of pregnancy.
International Journal of Research in Medical Sciences, 2016
Background: Intra uterine growth restricted (IUGR) is when the expected foetal weight is less than 10 th percentile for gestational age. The hemodynamics of the feotus takes into account both the umbilical-placental and cerebral vascular beds. Underlying etiology that results in the failure of a foetus to attain its expected growth may vary. However the final infliction is via uteroplacental insufficiency. It is highlighted that inadequate uteroplacental perfusion is the main and primary pathology in growth restriction resulting in an increased umbilical artery impedance. Following this step are the changes in the middle cerebral artery (MCA) which categorically set in as a secondary phenomenon. Methods: Duplex Doppler Sonography is a reliable, non-invasive and rapid diagnostic technique in IUGR patients. Grey scale findings together with colour Doppler characteristics help in the qualitative as well as quantitative evaluation of the Uteroplacental and Fetoplacental circulation. Hence ultrasonography (USG) has become the most widely used, standard and simple way of detecting and confirming IUGR. Ultrasound biometry is the gold standard for assessment of foetal size. Various criteria are used to label a feotus growth restricted; foetal weight less than 10th percentile for gestational age is mostly widely accepted criterion. Others like elevated HC/AC ratio, elevated FL/AC ratio, and presence of oligohydramnios without ruptured membranes, presence of advanced placental grade can also be used for improving the accuracy of diagnosis. After establishing the diagnosis of IUGR, Doppler imaging becomes a valuable investigating method for monitoring the pregnancy because it provides information about the hemodynamic status of the feotus. Uteroplacental system evaluation takes into account the flow pattern of uterine artery, reflecting any underlying Uteroplacental vascular ischemia. Umbilical artery Doppler waveforms reflect the status of the fetoplacental circulation and any underlying placental insufficiency. Results: Fourteen cases showed absent umbilical artery end diastolic flow and four patients showed reversal of end diastolic flow.: Twenty two patients showed elevated PI. Adverse perinatal outcome was observed in all patients with absent and reversal of end diastolic flow. Out of the twenty two with elevated PI fifteen showed adverse outcome. Thirty six cases showed low MCA PI and six showed a pseudonormalization. A cerebro-placental ratio of < 1.08 was observed in 16 patients, it was calculated in only those pregnancies that showed forward diastolic flow in umbilical artery (n= 22). Fifteen of them showed adverse perinatal outcome. Conclusions: Doppler imaging is of value for monitoring pregnancies complicated with IUGR because it can provide indirect evidence of foetal compromise and is known to improve outcome of high risk pregnancies. Doppler evaluation is complementary to all other surveillance modalities. Because the changes in umbilical, uterine & MCA strongly correlate with pregnancy outcome in growth restricted foetuses the use of foetal biometry & Doppler examination is recommended in all cases of suspected IUGR cases.
Doppler Velocimetry of Umbilical Artery in Normal and Growth Restricted Pregnancy
Bangladesh Journal of Obstetrics & Gynaecology, 2022
Objectives: To evaluate the umbilical arterial blood flow velocity and its various indices during 3rd trimester of pregnancy and to compare these indices in normal and growth restricted pregnancies. Methods: In this study, 50 women with normal singleton pregnancy and 50 women with intrauterine growth restricted (IUGR) pregnancy with expected birth weight <10th percentile of the normal for the gestational age were studied by Doppler evaluation of their umbilical artery, Pulsality Index (PI), Resistance Index (RI) and S/D ratio of the control group and IUGR group were calculated and reference range constructed. Values of Doppler indices of IUGR group were compared with those of the control group. Perinatal outcome was evaluated in relation to the indices. Results: Doppler velocimetry of umbilical artery showed elevated indices in 33 out of 50 cases of IUGR group showing its high sensitivity in diagnosing haemodynamically compromised growth restricted fetuses. Absent end diastolic v...
2019
Original Research Article This was prospective study carried out in -Khartoum state –Sudan, Khartoum Bahri Teaching hospital in the period from august 2016 to December 2018. The main aim of the study was to assess umbilical arteries and outcome in 33-46 weeks GA using Doppler ultrasound. The study was done in 197 pregnant women with normal singleton pregnancy with mean age 28 years, with gestational age by Last Menstrual period (GA LMP) 33-46 weeks, classified into three group (Group one in GA ranged 33-38 weeks 6 days, Group two in age group 39 weeks -40 weeks (term) and Group three 40 weeks 1day to 46 weeks GA LMP (post-term) , no maternal medical condition that may affect pregnancy outcome such as diabetic and hypertension. The data was collected by data collection sheet designed especially for this study and including all variables; then analyzed by statistical package for social sciences (SPSS). The study found that most of them were nulliparous 78.8%. Significant difference in...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Background: Intrauterine growth restriction (IUGR) is a major and silent cause of perinatal morbidity and mortality. Rate of IUGR in developing countries is 6 times higher than that of developed countries. 14 to 20 million infants are affected with IUGR in developing countries annually. The highest incidence is found in south central Asia (33%) and India (21%). Aim of study was to evaluate the role of early 3rd trimester ultrasound in diagnosis and role of color Doppler in prediction of adverse perinatal outcome in IUGR.Methods: A prospective case-control study was conducted on 720 women admitted in GMH Rewa for one year. 360 antenatal cases diagnosed as IUGR on ultrasound were taken as study group, same number of non IUGR cases were taken as control. Study cases were followed with Doppler. The umbilical artery pulsatility index (UA PI), middle cerebral artery pulsatility index (MCA PI) and cerebro-placental ratio were calculated and the results were analysed.Results: Inferences dra...
Doppler Prediction of Adverse Perinatal Outcome in Intrauterine Growth Restriction
International journal of reproduction, contraception, obstetrics and gynecology, 2015
Background: Objective of current study was to determine and compare the diagnostic performance of Doppler ultrasonography of the fetal Middle Cerebral Artery (MCA) and Umbilical Artery (UA) for prediction of adverse perinatal outcome in suspected intrauterine growth restriction (IUGR). Methods: Fifty singleton pregnancies in third trimester of pregnancy with suspected intrauterine growth restriction were examined with Doppler ultrasonography of fetal MCA and UA. Results: Twenty patients of the fifty included patients had at least one major or minor adverse outcome. Major adverse outcome included perinatal deaths which included both intrauterine deaths and early neonatal deaths, hypoxic ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage, necrotizing enterocolitis and septicemia. Minor outcomes included cesarean section for fetal distress, Apgar score below 7 at 5 minutes and admission to Neonatal Intensive Care Unit (NICU) for treatment. MCA PI is the most sensitive(90%) index in predicting any adverse perinatal outcome i.e. including both major and minor outcomes, Positive Predictive Value (PPV) and specificity being greatest for MCA/UA PI (96.6%, 93.7%). For the major adverse outcome most sensitive (86.6%) most specific (91.4%) and with highest PPV (81.2%) and NPV (94.1%), is MCA/UA PI. Ratio of MCA/UAPI is more sensitive (90%) than PI of both the arteries alone for overall prediction of adverse perinatal outcome. Conclusions: Thus we conclude that the Doppler studies of the multiple vessels in the fetoplacental unit can help in the monitoring of the compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of deliveries in pregnancies complicated by IUGR.
2020
Background Intrauterine growth restriction is defined as a fetal weight below the 10th percentile for a given gestational age and can be identified using umbilical artery Doppler velocimetry which is a non-invasive technique. The objective of this study was to determine the perinatal outcome of growth-restricted fetuses with abnormal umbilical artery Doppler study compared to those with normal umbilical artery Doppler waveforms at a tertiary referral hospital in Ethiopia. Methods A prospective cohort study was conducted among pregnant mothers with fetal growth restriction admitted for labour and delivery from September 2018-February 2019. The data were entered and analyzed using SPSS version 23. After conducting descriptive analysis, exploring the entire data, and checking for, statistical associations between abnormal umbilical artery Doppler and outcome variables, multiple logistic regression was conducted to control for confounders. Results A total of 170 pregnant mothers complic...