Value of Middle Cerebral/Umbilical Artery Resistance Index Ratio in Neonatal Outcome in Patients with Intrauterine Growth Restriction (Prospective Study)

Abstract

Background: Fetal growth disorders are usually associated with perinatal morbidity and mortality. Accurate assessment of intrauterine fetal growth is difficult, but recent advances have improved with positive implications for antenatal care.Aim of the work: The aim of this study was to assess the accuracy of the umbilical and middle cerebral artery resistance index in prediction of fetal outcome in pregnancies with intra-uterine growth restriction (IUGR).Patients and Methods: Forty-five pregnant females had been included in a prospective study. All had a confirmed diagnosis of intra-uterine growth restriction (IUGR). Doppler ultrasound had been performed to record fetal umbilical and middle cerebral artery (MCA) resistance indices every one week (from 32 weeks onwards). Post-delivery birth weight of the baby, Apgar score at 0 and 5 minutes had been documented and correlated with doppler indices. Results: One-fifth of the mothers participating in the study (20%) had pre-term birth and 6.7% missed the follow-up. Umbilical artery resistance index (RI) at a cut off value of (0.79) had a diagnostic accuracy of 93%. MCA RI best cut off value was 0.63 with diagnostic accuracy of 73.9%. Also, for C/U ratio had diagnostic accuracy of 92.9%. Finally, there was significant, proportional correlation between MCA RA and C/U ratio from one side and APGAR score at 0 and 5 minutes from the other side. However, the correlation between UARI and Apgar score was inverse and statistically significant. Conclusion: Doppler velocimetry of fetal circulation can provide important information regarding fetal well-being, with subsequent impact on fetal outcome.