A retrospective study of umbilical artery S/D ratio assessment on color doppler for monitoring of fetal well-being in patients with intrauterine growth retardation and its correlation with perinatal outcomes
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20234093Keywords:
Umbilical artery doppler, IUGR, Non-invasive testAbstract
Background: Intrauterine growth restriction (IUGR) is associated with an increased risk of perinatal morbidity, mortality and impaired neurodevelopment. The objective of this study is to evaluate the role of umbilical artery S/D ratio on color doppler for monitoring of fetal well-being in patient with intrauterine growth retardation and correlation with perinatal outcome.
Methods: This retrospective observational study is carried out at a tertiary health care hospital over a period of 1 year. All clinically diagnosed cases of IUGR on the basis of fundal height are included in this study. The suspected cases of IUGR, color doppler tests were done to confirm the diagnosis of IUGR. The perinatal outcomes of the pregnancy of women with abnormal doppler parameters are then compared with women with normal Doppler parameters.
Results: Out of the total sample size, 58.7% of the study population had abnormal doppler findings which were suggestive of IUGR, and 41.3% had normal doppler parameters. Our study showed that 18.2% newborns of study participants with abnormal S/D ratio had APGAR score at 5 minutes less than 7 as compared to 0% neonates of study participants with normal S/D ratio. This association was statistically significant. Also, statistically significant association was seen between 40 (90.9%) participants having abnormal S/D ratio whose neonates required NICU Admission as compared to 15 (48.4%) study participants having normal S/D ratio whose babies required NICU admission.
Conclusions: Ultrasound examination and Doppler monitoring provide a non-invasive repetitive method for supervising fetuses with growth restriction in order to apply an adequate management.
References
Gilbert WM, Danielson B. Pregnancy outcomes associated with intrauterine growth restriction. Am J Obstet Gynecol. 2003;188(6):1596-9.
ACOG Practice bulletin no. 134: fetal growth restriction. Obstetr Gynecol. 2013;121(5):1122-33.
Florio P, Marinoni E, Di Iorio R Moataza B, Sabina C, Renata S et al. Urinary S100B protein concentrations are increased in intrauterine growth-retarded newborns. Pediatrics. 2006;118(3):e747-54.
Turan OM, Turan S, Berg C, Gembruch U, Nicolaides KH, Harman CR et al. Duration of persistent abnormal ductus venosus flow and its impact on perinatal outcome in fetal growth restriction. Ultrasound Obstetr Gynecol. 2011;38(3):295-302.
Du Plessis AJ. Cerebral blood flow and metabolism in the developing fetus. Clin Perinatol. 2009;36(3):531-48.
Scifres CM, Stamilio D, Macones GA, Odibo AO. Predicting perinatal mortality in preterm intrauterine growth restriction. Am J Perinatol. 2009;26:723-8.
Fleischer A, Schulman H, Farmakides G, Bracero L, Blattner P, Randolph G. Umbilical artery velocity waveforms and intrauterine growth retardation. Am J Obstet Gynecol. 1985;151(4):502-5.
Simanaviciute D, Gudmundsson S. Fetal middle cerebral to uterine artery pulsatility index ratios in normal and pre-eclamptic pregnancies. Ultrasound Obstet Gynecol. 2006;28:794-801.
Acharya D, Kondagunta N, Sreekumaran N. Maternal Determinants of Intra Uterine Growth Retardation: A Case Control Study in Udupi District, Karnataka. Indian J Community Med. 2004;29(4).
Barbara B. Fundal height measures for IUGR often unreliable. OB/GYN News. 2010.
Murakoshi T, Sekizuka N, Takakuwa K, Yoshizawa H, Tanaka K. Uterine and spiral artery flow waveforms in pregnancy induced hypertension hypertension and/or intrauterine growth retardation. Ultrasound Obstet Gynecol. 1996;7(2):122-8.
Bais JMJ, Martine E, Pel M, Bonsel GJ, Bleker OP. Effectiveness of detection of intrauterine growth retardation by abdominal palpation as screening test in a low risk population: an observational study. Eur J Obstet Gynecol Reprod Biol. 2004;116(2):164-9.
