Role of venous Doppler evaluation of intrauterine growth retardation

Abstract

Aim of the workThe aim of this work is to determine the role of venous Doppler Ultrasonography for the prediction of adverse perinatal outcome in “intrauterine growth restricted fetus”, providing the obstetrician with additional information about the time frame and significance of the IUGR to help determine the optimal time of delivery. Patients and methodsSixty pregnant females with their age ranging between 28 and 35years, gestational age between 27 and 37weeks of gestation were enrolled in the study. All patients in the study were subjected to Doppler examination of the umbilical vein (UV), Ductus venosus (DV), right hepatic vein (HV) and umbilical artery (UA). ResultsAbnormal UA Doppler was found in 40 patients. Abnormal DV Doppler was found in 40 patients. Abnormal UV Doppler was found in 10 patients. Abnormal Rt. HV Doppler was found in 20 patients. All parameters studied were strongly related to perinatal mortality, however, none had 100% sensitivity, the pulsatility index in the Rt. HV and DV were the best single indices to use in the prediction of perinatal mortality. ConclusionWe observed that venous Doppler is superior to arterial Doppler in predicting poor perinatal outcome and that the abnormal equivocal BPP scoring significantly correlated with adverse outcome. We also, concluded that multi-vessel Doppler Ultrasonography and BPP can effectively stratify IUGR fetuses with placental vascular insufficiency into risk categories. Fetal deterioration appears to be independently reflected in these two testing modalities; their combined use is likely to be complementary.