Umbilical Artery Doppler Flow Velocimetry in Intrauterine Growth Restriction and its Relation to Perinatal Outcome

Abstract

Materials and methods: A retrospective data analysis was conducted on antenatally detected intrauterine growth restricted (IUGR) fetuses born between 26 and 38 weeks of gestational age with high resistance Doppler flow (HRDF) and absent or reversed end-diastolic flow (AREDF), excluding multiple gestations. The data was collected using an obstetric information management system and evaluated. About 152 cases were identified over a 5-year period in our tertiary referral center. The patients were divided into two groups: those with elevated systolic/diastolic ratio group of 95th or more percentile (n = 123, 81%) and those with absent/reversed end-diastolic flow (n = 38, 19%). Maternal characteristics and perinatal outcomes of these groups were comparatively analyzed. Results of umbilical artery Doppler showed a significant correlation with the perinatal outcome. The poor perinatal outcome was 26% in those with absent or reversed diastolic flow in Doppler, as compared to only 1% in those with increased Doppler flow. Using Fischer’s exact test, the result is statistically significant (p < 0.05). Predictors of nonsurvival were the presence of reversed end-diastolic flow and preterm <30 weeks of gestation. Nonsurvivors had a significantly lower gestational age at diagnosis and delivery. Conclusion: Antenatal umbilical artery Doppler is shown as a significantly efficient marker in predicting perinatal outcomes in IUGR fetuses. Severely abnormal umbilical artery blood flow poses a significant risk for pregnancy, while perinatal mortality is also dominated by gestational age at diagnosis and delivery.