P05.25: Timing of delivery of IUGR fetuses on the basis of hemodynamic changes

Abstract

Objective: to evaluate the morbidity and mortality rate of IUGR fetuses correlated to Doppler velocimetry, FHR tracing, BPP and AFI. Methods: a multicenter prospective study of 246 fetuses with ultrasound diagnosis of IUGR. Among them 186 met the study entry criteria. The study group underwent Doppler velocimetry study of UA, MCA, DV and UV twice weekly, BPP and AFI twice weekly and FHR tracing daily. IUGR fetuses were divided into two groups: Group 1 IUGR fetuses with Doppler velocimetry abnormality; Group 2 with normal Doppler velocimetry. In Group 1 the type and time passing from Doppler alteration to birth were documented. Apgar score, pH at birth, need of intubation, RDS, IVH, PVL, days of NICU hospitalization were available and related to neonatal outcome. Results: Gestational age at time of admission ranged from 16.1 to 40 weeks. One hundred IUGR fetuses showed Doppler velocimetry alteration while sixty-eight fetuses did not show Doppler alteration (Group 2). In Group 1 morbidity and mortality rate were significantly correlated with the type of Doppler velocimetry abnormality and with time passing from the latter finding and delivery being higher in fetuses with AEDF, RF in UA with a time >72 hours from the Doppler abnormality and delivery. Conclusions: Doppler velocimetry should be performed in IUGR fetuses as its findings help to reduce morbidity and mortality rate. There is a significant correlation between the type of alteration and time passing from alteration to birth.