A study of various fetal Doppler indices to assess outcome in growth restricted fetuses: a comparative and cross-sectional study

Rishi A. Gupta; Mamta N. Anand; Jaynarayan B. Senapati; Prajakta More

doi:10.18203/2320-1770.ijrcog20262788

Authors

Rishi A. Gupta Department of Obstetrics and Gynecology, Rajiv Gandhi Medical College, Thane, Maharashtra, India
Mamta N. Anand Department of Obstetrics and Gynecology, Rajiv Gandhi Medical College, Thane, Maharashtra, India
Jaynarayan B. Senapati Department of Obstetrics and Gynecology, Rajiv Gandhi Medical College, Thane, Maharashtra, India
Prajakta More Department of Obstetrics and Gynecology, Rajiv Gandhi Medical College, Thane, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20262788

Keywords:

Fetal growth restriction, Doppler velocimetry, Umbilical artery, Middle cerebral artery, Ductus venosus, Perinatal outcome

Abstract

Background: Fetal growth restriction (FGR) poses significant risks of adverse perinatal outcomes. Accurate surveillance is essential to distinguish pathologically growth-restricted fetuses from constitutionally small infants and to optimize the timing of delivery.

Methods: A comparative cross-sectional observational study was conducted at Rajiv Gandhi Medical College among 118 singleton pregnancies (≥32 weeks) with diagnosed FGR. Comprehensive doppler velocimetry of the umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) was performed and categorized into doppler grades 0 to 5. Primary outcomes evaluated were perinatal morbidity, neonatal mortality, APGAR scores, and birth weight.

Results: Normal doppler (grade 0) was present in 98 (83.1%) participants, while 20 (16.9%) exhibited abnormal doppler indices. Abnormalities in UA, MCA, and DV were strongly associated with adverse outcomes (p<0.001). Grade 0 doppler showed a high association with normal neonatal outcomes (odds ratio=24.14, p<0.001). Conversely, severe doppler deterioration (grade 4 and grade 5) was significantly associated with perinatal morbidity (p=0.037) and neonatal mortality (p=0.011), respectively. Infants with abnormal doppler had significantly lower gestational age at delivery (35.35±2.30 vs 37.22±0.58 weeks, p=0.001), lower APGAR scores at 5 minutes (6.10±3.09 vs 8.53±0.61, p<0.001), and reduced birth weights (1.67±0.44 kg vs 2.09±0.14 kg, p<0.001).

Conclusions: Fetal doppler surveillance effectively stratifies risk in growth-restricted fetuses. Abnormal doppler indices correlate strongly with hemodynamic compromise and adverse perinatal outcomes, providing critical evidence to guide timely clinical intervention prior to irreversible fetal acidemia.

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