Author(s): G. V. Prasad1, Jyothi2, Sarvottam3
Intrauterine growth retardation (IUGR) is a fetal growth disorder defined on the basis of a fetal weight below 10th percentile for the corresponding gestational age. Our study was an effort at establishing the role of Umbilical artery (UA) and Middle cerebral artery (MCA) Doppler indices in predicting the adverse perinatal out come in clinically suspected IUGR pregnancies, and to determine the role of Doppler velocimetry in clinical management of such pregnancies. Elevation of the umbilical artery systolic/diastolic ratio or of the pulsatility index (PI); absent or reversed end-diastolic flow in the umbilical artery and decreased systolic/diastolic ratio or pulsatility index in the fetal internal carotid and middle cerebral arteries are the predictors of abnormal perinatal outcome. Our study was to evaluate the role of ratio of pulsatility index (PI) which is called as Cerebroplacental Ratio i.e. MCAPI/UAPI Doppler ratio as the most accurate predictor of adverse perinatal outcome among women with clinical suspicion of IUGR attending our (SVRR Govt.) hospital. METHODOLOGY: 50 Antenatal women attending the antenatal O.P.D who were clinically suspected as having growth retardation based on clinical history of previous child with growth retardation, signs of pallor ( anaemia ) and high documented Blood pressures –s/o PIH, reduced abdominal height for gestational age,were evaluated using screening ultrasound.Doppler velocity wave forms were obtained from umbilical artery and fetal middle cerebral artery from all the 50 cases. 16 cases were followed up with repeat Doppler.Pulsatility index ratio of middle cerebral artery and umbilical artery, also called as Cerebroplacental ratio was evaluated in each case. Abnormal ratio is defined as Cerebroplacental ratio <1.08 was considered as a cut off value. Ratio was calculated and correlated clinically with the perinatal outcomes – in the form of IUD’s, low APGAR scores and admission into ICU.