Abstract
Objective The purpose of this study was to assess the accuracy of the middle cerebral artery (MCA) and umbilical artery (UA) Doppler indices in predicting fetal outcome in pregnancies complicated by preeclampsia and/or intrauterine growth retardation (IUGR). Study design It was a prospective study. Patients and methods One hundred and twenty-one pregnant women were categorized into four groups: group A, preeclampsia without IUGR group (38 cases); group B, IUGR without preeclampsia group (24 cases); group C, preeclampsia complicated with IUGR group (19 cases); and group D, the control group (40 cases). The perinatal outcomes correlated to the results of UA and MCA Doppler indices and cerebroplacental ratio (CPR). The accuracy of UA and MCA Doppler indices and CPR in the prediction of adverse outcome was calculated. Results Adverse neonatal outcome in group A was significantly correlated to UA-resistance index (RI) and UA-pulsatility index (PI) (r=0.537, P<0.001; r=0.405, P=0.0116, respectively). However, it showed no significant correlation with other parameter of Doppler indices and CPR. In group B, it was significantly correlated to all Doppler parameters indices and CPR. UA-RI and CPR were stronger parameters, to predict adverse neonatal outcome, than other parameters, with r-value of 0.869 and 0.803, respectively. In group C, it was significantly correlated to UA-RI and UA-PI, MCA-RI, and CPR. However, it showed no significant correlation with MCA-peak systolic velocity. CPR and UA-RI were stronger parameters, to predict adverse neonatal outcome, than other parameters, with r-value of 0.677 and 0.631, respectively. In group D, it was significantly correlated to UA-RI, UA-PI, and CPR. However, it showed no significant correlation with other parameters of Doppler indices. UA-RI and UA-PI were stronger parameters, to predict adverse neonatal outcome, than CPR, with r-value of 0.789 and 0.787, respectively. Conclusion The primary aim of antepartum surveillance is timely recognition of fetal compromise to enable appropriate intervention and to prevent further serious complications. MCA and UA Doppler indices are good utilities for the assessment of fetal well-being and prediction of neonatal outcome in pregnant women with IUGR and/or preeclampsia. CPR and MCA-peak systolic velocity are strong parameters to predict the adverse neonatal outcome in pregnant women with IUGR.
Published Version
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