The value of colour doppler assessment of the uteroplacental circulation in predicting intrauterine growth restriction


  • Vimla Dhakar Department of Obstetrics and Gynecology, GMCH, Udaipur, Rajasthan, India
  • Sabiha Naz Department of Obstetrics and Gynecology, GMCH, Udaipur, Rajasthan, India



IUGR, Notch, Resistance index, S/D ratio, Uterine artery Doppler, Umbilical artery Doppler


Background: Intrauterine growth restriction is a complication that arises due to decrease in uteroplacental blood flow during pregnancy. This decrease is associated with a pathological condition of spiral arteries thought to arise during placentation in first trimester of pregnancy. Thus, it might be possible to predict the development of these conditions by assessing uteroplacental blood flow in pregnancy with colour Doppler. The aim of the study was to assess the findings of Doppler data in predicting IUGR and finding the best predictors of IUGR in uterine and umbilical artery Doppler.

Methods: In this prospective study, total of 100 women with high risk pregnancy attending Department of Obstetrics and Gynecology at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This study was carried over a period of 1 year from 2015-2016.

Results: Out of total 100 patients, 8 were found to have IUGR. Out of different parameters, Notch is the best indicator with high sensitivity and highest positive predictive value (PPV) of 50% followed by combination of parameter as it had the highest sensitivity of 62.5% for uterine artery Doppler. S/D Ratio is the best indicator with high sensitivity and highest positive predictive value (PPV) of 25% and 40% respectively followed by RI with highest sensitivity of 42.86% for umbilical artery Doppler.

Conclusions: Value of Doppler assessment of uteroplacental circulation in predicting IUGR and is very useful in improving pregnancy outcome.


Xiao R, Sorensen TK, Williams MA, Luthy DA. Influence of pre-eclampsia on fetal growth. J Matern Fetal Neonatal Med. 2003;13:157-62.

Bewley S, Copper D, Campbell S. Doppler investigation of uteroplacental blood flow resistance in the second trimester; A screening test for pre-eclampsia and IUGR. Br J Obstet Gynecol. 1991;98:871-9.

Jasovic-Siveska EI, Jasovic VI. Real time ultra sound in the detection of IUGR in pre-eclampsia. Bratisl Lek Lisky. 2008;109(9);405-11.

Kurdi W, Campbell S, Aquilina J, England P, Harrington K. the role of colour Doppler imaging of the uterine arteries at 20 weeks of gestation in stratifying antenatal care. Ultrasound Obstet Gynecol. 1988;12:339-45.

Moldenhaurer JS, Stanek J, Warshak C, Khoury J, Sibai B. The frequency and severity of placental findings in women with Pre eclampsia and IUGR are dependent on gestational age. Am J Obstet Gynecol. 2003;189:1173-7.

Sebire NJ, Goldin RD, Regan L. Term pre-eclampsia is associated with minimal histopathological placental features regardless of clinical severity. J Obstet Gynaecol. 2005;25:117-8.

Bhide A, Acharya G, Bilardo CM Brezinka C, Cafici D, Hernandez-Andrade E, et al. ISUOG practice guidelines: use of Doppler ultrasonography in obstetrics. Ultrasound Obstet Gynecol. 2013;41:233-9.

Griffin JB, Lokomba V, Landis SH, Thorp JM, Herring AH, Tshefu AK, et al. Plasmodium falciparum parasitaemia in the first half of pregnancy, uterine and umbilical artery blood flow, and foetal growth: A longitudinal Doppler ultrasound study. Malar J. 2012;11:319.

Hecher K, Campbell S, Doyle P, Harrington K, Nicolaides K. Assessment of fetal compromise by Doppler ultrasound investigation of the fetal circulation. Arterial, intracardiac, and venous blood flow velocity studies. Circulation 1995;91:129-38.

North RA, Ferrier CL, Long D, Townend K, Kincaid Smith F. Uterine artery Doppler flow velocity waveforms in the second trimester for the prediction of pre-eclampsia and IUGR. Obstet Gynecol. 1994;83:378-86

Irion O, Masse J, Forest JC, Mountquin JM. Prediction of pre-eclampsia, IUGR and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparous women. Br J Obstet Gynecol. 1998;105:402-25.

Bower S, Susan B, Campbell S. Improved prediction of pre-eclampsia by two stage screening of uterine arteries using the early diagnostic notch and colour Doppler imaging. 1993;82:78-83.

Antsaklis A, Daskalakis G. The effect of gestational age with placental location on the prediction of pre-eclampsia. Uterine artery Doppler velocimetry in low risk nulliparous women. Obstet Gynecol 2000;16:635-9.

Beattie RB, Dornan JC. Antenatal screening for IUGR with umbilical artery Doppler ultrasonography. Br J Obstet Gynecol. 1989;298:631-5.

Gómez O, Figueras F, Fernández S, Bennasar M, Martínez JM, Puerto B, et al. Reference ranges for uterine artery mean pulsatility index at 11-41 weeks of gestation. Ultrasound Obstet Gynecol. 2008;32:128-32.

Kurmanavicius J, Florio I, Wisser J, Hebisch G, Zimmermann R, Müller R, et al. Reference resistance indices of the umbilical, fetal middle cerebral and uterine arteries at 24-42 weeks of gestation. Ultrasound Obstet Gynecol. 1997;10:112-20.






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