Doppler ultrasound in intrauterine growth retardation and its indices in correlation with gestational age
Background and objective: Intrauterine growth retardation remains the most frequent cause of perinatal morbidity and mortality. Doppler ultrasound has become an indispensable tool in evaluating pregnancies at risk, on the basis of the vascular resistance to blood flow. This study aimed to evaluate non-invasively the fetoplacental and uteroplacental circulations in clinically confirmed high-risk pregnancies, using Doppler parameters of some vessels to apply clinical interventions which could result in reduced prenatal morbidity and mortality and help to decide the type of delivery.
Methods: This cross-sectional study was conducted in Duhok city from June 2014 to January 2015. The study involved 100 pregnant women between 26–42 weeks of gestation with known last menstrual period and a definite clinical high-risk for intrauterine growth retardation. Various Doppler indices were performed including the resistive index, pulsatility indices of both umbilical and middle cerebral arteries, and the resistive index of the uterine artery to predict fetal health, correlated with physical and clinical outcomes, taking into consideration the variability in Doppler measurements of gestational age. Data have been described and then analyzed statistically for their correlation with gestational age.
Results: Umbilical artery and fetal middle cerebral artery Doppler indices are correlated inversely with gestational age. Although the uterine artery has a major role in Doppler examination of high-risk pregnancies, there is only a weak correlation between maternal uterine artery Doppler index and gestational age in late pregnancy. Doppler measurement of three arteries was more conclusive and show more sensitivity than one arterial Doppler measurement in the third trimester.
Conclusion: Significant inverse correlations were found between Doppler indices of fetal middle cerebral and umbilical arteries, and gestational age, while the correlation with maternal uterine artery index was not significant with advancing gestational age.
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