Role of uterine artery Doppler in prediction of FGR in high risk pregnancies in 20-24 weeks
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20171396Keywords:
Diastolic notch, FGR, Uterine artery dopplerAbstract
Background: Accurate prediction of fetal growth retardation (FGR) is a long-sought goal of perinatology as it contributes significantly to perinatal mortality and morbidity. It generally manifest later in pregnancy, their underlying pathophysiology is largely established early in pregnancy. Early detection will help in decreasing the associated morbidity.
Methods: The study was carried out on 100 pregnant women of 20-24 weeks gestation in the Department of Obstetrics and Gynecology, MGM Medical College and MY Hospital, Indore from March 2015 to February 2016.Presence of diastolic notch in uterine artery waveform was taken as screen positive.
Results: Total Diastolic notch positive cases 20/100 out of which 60% developed FGR and 80/100 Diastolic notch negative cases out of which only 4 cases (5%) will developed FGR. The sensitivity of the test was 75% while the specificity was 90.47%. The positive predictive value was 60% while the negative predictive value was 89.74%. 50% of screen positive belonged to 30-39 year age group and 68.75% FGR was seen in primiparous.
Conclusions: Study of uterine artery flow velocity waveform seems to be a modern technique which can be used for ruling out the probability of FGR. Presences of diastolic notch in uterine vessels in 2nd trimester are of prognostic value for maternal complications and fetal jeopardy and therefore need of further critical assessment and management.
References
Kozuki N, Lee ACC, Silveira MF, Sania A, Joshua P Vogel JP, Adair L et al. The associations of parity and maternal age with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis. BMC Public Health. 2013;13:S2
Chourasia S, Agarwal J, Dudve M. Clinical assessment of intrauterine growth restriction and its correlation with fetal outcome. Journal of Evolution of Medical and Dental Sciences. 2013;2(41):7944-50.
Gómez O, Martínez JM, Figueras F, Del Río M, Borobio V, Puerto B et al. Uterine Artery Doppler at 11-14 weeks of gestation to screen for hypertensive disorder and associated complication in an un selected population. Ultrasound Obstet Gynecol. 2005;26(5):490-4.
Poon L, Staboulidou I, Maiz N, Plasencia W, Nikolaides K. Hypertensive disorders in pregnancy: Screening by uterine artery Doppler at 11-13 weeks. Ultrasound Obstet Gynecol. 2009; 34:142-8.
Harrington K, Carpenter RG, Goldfrad C, CampbellS. Transvaginal doppler ultrasound of the uteroplacental circulation in the early prediction of pre-eclampsia and IUGR. Br. J. Obstet Gynaecol 1997;104;674-81.
Aquilina J, Barnett A, Thompson O, Harrington K. Comprehensive analysis of uterine artery flow velocity waveform for the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2000;16(2):163-70.
Barati M, Shahbazian N, Ahmadi L, Masihi S. Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences. 2014;19(6):515-9.
Papageorghiou AT, Yu CKH, Bindra R, Pandis G, Nicolaides KH. Multicenter screening for pre-eclampsia and fetal growth restriction by transvaginal uterine artery Doppler at 23 weeks of gestation. Ultrasound Obstet Gynecol. 2001;18:441-9.
Singh S, Verma U, Shrivastava K, Khanduri S, Goel N, Zahra F. Role of color doppler in the diagnosis of intra uterine growth restriction (IUGR). IJRCOG. 2013;2(4):566-72.
Coleman MAG, McCowan LME, North RA. Mid-trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high-risk women. Ultrasound in Obstet Gynecol. 2000;15:7-12.
