The analysis of Doppler flow alterations in intrauterine growth restricted pregnancies

Abstract

Objective: Intrauterine growth restriction (IUGR) is a common clinical condition. For some clinicians, it is still not clear which patients should be referred to a tertiary center. In this study, we aimed to analyse the sonographic parameters of IUGR suspected pregnancies and find out which finding is the most sensitive in the diagnosis of IUGR. Methods: Doppler flow findings and biometric measurements of 50 IUGR suspected pregnancies admitted to our perinatology outpatient clinic between March 2013 and March 2014 were evaluated. 60 healthy singleton pregnancies were assigned as the control group. The same measurement were performed and compared. The diagnosis of IUGR was made on one of the followings: AC measurement ? 10 p, uterine artery RI ?0.58, the fetal growth rate ? 10 p, fetal weight ? 10 p. Gestational week was calculated regarding the last menstrual period and confirmed with the first trimester ultrasonographic findings. Results: In IUGR and control group, maternal age was 26.63 ± 5.19 and 29.48 ± 5.79, respectively (p=0.327); gravida was 1.74 ± 0.99 and 2.13 ± 1.51 (p=0.290); parity was 0.63 ± 0.89 and 0.98 ± 0.49, (p=0.703); gestational week was 34.82 ± 3.27 and 34.21 ± 4.07 (p=0.70), respectively. Umbilical artery PI was 1.51 ± 0.96 in IUGR group and 1.00 ± 0.22 in control group (p1 and umbilical artery PI >0.95 have the highest sensitivity for IUGR (Sensitivity 82% and 80%; specificity 56% and 44%, respectively). Oligohydramnios and UA/MCA PI ratio were shown to have the highest specificity (specificity 70%).

Keywords

• IUGR, HC/AC, Oligohydramnios, umbilical artery PI, cerebral artery PI

The analysis of doppler flow alterations in intrauterine growth restricted pregnancies

Öz

References

1. gynecology;122:248-54. 5.
2. Barker ED, McAuliffe FM, Alderdice F, Unterscheider J,
3. Daly S, Geary MP, et al. The role of growth trajectories in
4. classifying fetal growth restriction. Obstetrics and
5. gynecology. 2013;122(2 Pt 1):248-54. 6.
6. Resnik R. Intrauterine growth restriction. Obstetrics and
7. gynecology. 2002;99(3):490-6. 7.
8. Williams RL, Creasy RK, Cunningham GC, Hawes WE,

9. Norris FD, Tashiro M. Fetal growth and perinatal viability
10. Kurmanavicius J, Florio I, Wisser J, Hebisch G,
11. Zimmermann R, Muller R, et al. Reference resistance
12. indices of the umbilical, fetal middle cerebral and uterine
13. arteries at 24-42 weeks of gestation. Ultrasound in
14. obstetrics & gynecology : the official journal of the
15. International Society of Ultrasound in Obstetrics and
16. Turan S, Miller J, Baschat AA. Integrated testing and
17. management in fetal growth restriction. Seminars in
18. perinatology. 2008;32(3):194-200.
19. Copyright © 2014 The Author(s); This is an open-access article distributed under the terms of the Creative Commons Attribution
20. License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium,
21. provided the original work is properly cited.