Role of colour doppler in predicting  adverse foetal outcomes in pre–eclampsia  & intra–uterine growth retardation  (IUGR).

Dr. Purvi B. Shah; Dr. Mili V. Dodia; Dr. Aparna V. Dodia; Dr. Apoorva V. Dodia

Volume : II, Issue : VII, July - 2013

Role of colour doppler in predicting adverse foetal outcomes in pre–eclampsia & intra–uterine growth retardation (IUGR).

Dr. Purvi B. Shah, Dr. Mili V. Dodia, Dr. Aparna V. Dodia, Dr. Apoorva V. Dodia

Abstract :

Purpose: To determine and compare the diagnostic performance of Doppler sonography of fetal middle cereal artery (MCA) and umbilical artery (UA) for prediction of adverse perinatal outcome in suspected intrauterine growth retardation (IUGR) and pre-eclampsia (PET). Materials and Methods: 116 Singleton pregnancies beyond 30 weeks of gestation complicated by intrauterine growth retardation and severe pre-eclampsia or both were prospectively examined with Doppler sonography of the UA & MCA. Results: Seventy-two patients of the 116 included in the study population had at least one major or minor adverse outcome. Major adverse outcome criteria included perinatal deaths - including intrauterine and early neonatal deaths, hypoxic ischemic encephalopathy, intra-ventricular haemorrhage, peri-ventricular leukomalacia, pulmonary haemorrhage and necrotizing enterocolitis. Minor outcomes included caesarean delivery for fetal distress, APGAR score below 7 at 5 minutes, admission to neonatal intensive care unit (NICU) for treatment. Conclusion: S/D ratio of MCA/UA is the most sensitive and specific index in predicting major perinatal adverse outcome (83% and 75%), while umbilical artery S/D ratio is the most sensitive index (66.6%) in predicting any adverse perinatal outcome i.e. including both major and minor outcome. MCA pulsatility index (P.I) is the most specific index (90.9%) for predicting in any adverse perinatal outcome. The sensitivity of the Doppler studies can be significantly increased by studying multiple vessels (91.6%). Hence we conclude that Doppler studies of multiple vessels in the fetoplacental circulation can help in the monitoring of compromised foetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of delivery in complicated pregnancies.