English

Abstract

OBJECTIVES : To search out IUGR cases on the basis of clinical examination (symphysiofundal height) & to confirm them with USG at 32 weeks of gestation. To validate Modified Biophysical Profile in all confirmed cases of IUGR from 32 weeks of gestation & all cases where AFI is decreased, NST is reactive & pregnancy is less than 36 weeks of gestation. To validate Complete Biophysical Profile & Color Doppler in cases: When pregnancy is less than 36 weeks of gestation & both NST & AFI are abnormal. STUDY DESIGN: prospective study carried out over 100 confirmed IUGR cases. MATERIALS AND METHODS: The IUGR cases were identified first by screening with SFH then confirmation with fetal abdominal circumference by USG at 32 weeks. All the cases were initially monitored with MBPP and BPP and color Doppler of Umbilical and MCA were performed in cases with abnormal MBPP having a non reactive NST. RESULTS: The incidence of IUGR was 3.86% in present study. The MBPP proved to be an effective tool for initial monitoring of IUGR cases with high specificity of 70.83%. The BPP and PI indices of Umbilical and middle cerebral arteries had good correlation with perinatal outcome i.e. BPP with sensitivity and PPV of 92.3% and 85.71%, Umbilical artery PI with sensitivity of 69.23% & positive predictive value of 90% and MCA PI with high specificity of 83.33% and PPV of 93.33%. CONCLUSION: MBPP is an effective initial surveillance tool in IUGR cases. The Biophysical profile, umbilical artery Doppler and Middle Cerebral artery Doppler have good correlation with perinatal outcome but further guidelines are required to integrate these surveillance modalities with each other.