Best color Doppler indices in prediction of fetal hypoxia in IUGR fetuses

Abstract

Objective: To determine the best predictor of fetal hypoxia amongst the color Doppler indices resistivity index(RI), pulsality index(PI) and systolic/ diastolic (S/D) ration of umbilical artery (UA), middle cerebral artery(MCA), descending abdominal aorta (DAA), MCA/UA PI ratio and abnormal flow pattern, absent end diastolic flow/reverse end diastolic flow (AEDF/REDF) in umbilical artery and descending abdominal aorta, in prediction of adverse perinatal outcome in normal and intrauterine growth retardation (IUGR) fetuses with or without pregnancy induced hypertension (PIH). Material and Method: 100 women with normal Singleton pregnancies and 100 women with IUGR with or without PIH or both were prospectively examined with Doppler Ultrasonography of the umbilical artery, middle cerebral artery & descending abdominal aorta and perinatal outcomes was evaluated in relation to their indices and compared with each other. Observation: In study group sixty four fetuses (64%) had one major or minor adverse perinatal outcome in comparison to control group which had only 6% adverse perinatal outcome. In study group premature delivery was 46%, lower segment cesarean section (LSCS) was 38%, and perinatal death was 22%. Fetuses with absent end diastolic flow/reverse end diastolic flow (AEDF/REDF) in umbilical artery and descending abdominal aorta had 100% perinatal mortality. Conclusion: Umbilical artery SD Ratio (cut off 3), middle cerebral artery / umbilical artery PI < 1.08, AEDF / REDF abnormal flow pattern in umbilical artery and descending abdominal aorta were found to be the best Doppler indices for prediction of adverse perinatal outcome in women with PIH and IUGR.