SMALL FOR GESTATIONAL AGE FETUS

Abstract

Objective: To evaluate the role of Colour Doppler Ultrasound in the management of small forgestational age fetus. SGA or IUGR. Design: Descriptive study. Place & duration of study: Study performed in theDeptt. of Radiology & Deptt. of Gynae. & Obstetrics in Allied Hospital, Faisalabad from August 2005 to July 2006.Material & Methods: This study was carried out on 45 patients admitted through antenatal clinic having suspicion ofcarrying small for gestational age fetus. A brief clinical record including age, parity, nutritional status, intercurrent illness,per-vaginum bleeding, history of drug intake, smoking, past obstetrical history was recorded. Methods involved inscreening SGA fetuses were measurement of Symphyseal Fundal Height chart & Ultrasound biometry, Biophysicalprofile (BPP), Cardiotocography (CTG), Middle cerebral and Umbilical Arteries Doppler studies were performed afteradmission in the management of SGA fetuses. All these information were recorded in a specially designed Performa.Results: Out of 45 SGA fetuses 15(33.3%) were constitutionally small, 20(44.4%) had history of pre-eclampsia,2(4.4%) had cardiac disease, 3(6.6%) had placental abnormalities, 5(11.1%) had multiple gestations. Gestation ofpatients ranged between 30-36 weeks. Umbilical Artery Doppler was used as the primary surveillance tool. Smallfetuses with normal Doppler and anomaly scan were managed on out-patient basis with fortnightly Doppler ultrasound.15 patients (33.3%) with normal end-diastolic flow were delivered at 37 weeks. 20 patients (44.47%) with absent orreversed end-diastolic flow were delivered at 34-35 weeks. 10 patients (22.2%) at 30 weeks gestation with abnormalDoppler study were managed on CTG (Cardiotocography) & biophysical profile over a period ranging between 1-14days. Perinatal mortality was 8.8% (4 cases) mostly due to extreme prematurity. Conclusion: Doppler ultrasound isa very helpful tool in the management of small for gestational age fetuses & it reduces perinatal morbidity & Mortality.