A study to evaluate umbilical artery and middle cerebral artery doppler indices as predictors of adverse perinatal out come in clinically suspected IUGR pregnancies

Abstract

Background and Objectives: Objective of our study was to evaluate the usefulness of middle cerebral artery and umbilical artery Doppler indices as predictors of adverse perinatal out come in clinically suspected IUGR pregnancies and to establish the role of Doppler ultrasound in the management of IUGR pregnancy. Materials and Methods: We studied Doppler Velocimetry of umbilical artery and Middle cerebral artery in 40 cases with clinical suspicion of IUGR between 31 to 40 weeks of gestation .Pulsatility Index was used as the Doppler index. Pregnancies with documented major congenital abnormality, multiple gestations and intrauterine death at the time of first Doppler examination were excluded from the study. Results: Cerebroplacental ratio (MCA/UA PI Ratio) was most sensitive (sensitivity 95%). It was more sensitive than either UA PI (sensitivity 90%) or MCA PI (sensitivity 76.19%) alone in predicting any adverse outcome. Diagnostic accuracy of Cerebroplacental ratio (Accuracy=92.50%) was better than UA PI (Accuracy=80%) and MCA PI (Accuracy=62.5%) in predicting adverse outcomes Conclusion: Fetal Doppler indices, in particular ratios that include measurements obtained from the cerebral circulation, help in the recognition of the compromised growth-retarded fetus.