The role of ultrasound in the prognosis of adverse perinatal outcome in fetuses with intrauterine growth restriction

Abstract

Background: Doppler ultrasound may indicate poor fetal prognosis by detecting abnormal blood flow waveforms. The study aimed to evaluate the Doppler ultrasound assessment on umbilical artery (UA) and middle cerebral artery (MCA) as a predictive marker of perinatal outcome in fetuses with intrauterine growth restriction (IUGR). Material and methods: A total of 126 IUGR pregnancies with a birth weight <10 percentiles were ultrasonographically evaluated. Doppler velocity in UA and MCA, was performed at 30.6-32.6 weeks of pregnancy. We considered adverse perinatal outcome: Apgar score ≤7 to 1 and 5 minutes, admission to the Department of Neonatal Intensive Care (NICU), gestational age <37 weeks at birth. Results: In the abnormal Doppler group, the newborns weight was 7±1.51 percentile, Doppler anomaly (absent/reversed end diastolic flow, UA-PI>95 percentiles, cerebro-placental ratio <1) determined the Apgar score of 6±0.75/1 minute and 7±0.64/5 minutes, a gestational age at birth of 36.2±1.01 weeks (premature birth), an admission to the NICU of 30.15% for neonates. Comparatively, in the normal Doppler group, the newborns weight was 9±1.03 percentile, the Apgar score was 8±0.95/1 minute and 9±0.76/5 minutes, the gestational age at birth was 37.4±0.99 weeks and admission to the NICU was required in only 12.69% of neonates of this group. Conclusions: Doppler antenatal monitoring may be a useful marker in the prognosis of perinatal evolution in fetuses with severe growth restriction.