Doppler in Ductus Venosus, Myocardial Performance Index and Aortic Isthmus in Fetal Growth Restriction and Comparison with Cerebroplacental Ratio

Abstract

Objectives: We studied the role of Doppler in the cerebroplacental ratio (CPR), ductus venosus (DV), aortic isthmus (AoI), and myocardial performance index (MPI) in early diagnosis late onset of fetal growth restriction (FGR) in relation to pregnancy outcomes. Materials and methods: Longitudinal case–control study was conducted over a period of 2 years between 2016 and 2018, and pregnant women of gestational age more than 28 weeks were included in the study. A total of 64 patients (32 controls and 32 patients with FGR) was evaluated with Doppler twice at entry and exit before termination of pregnancy. The perinatal outcome was analyzed. Results: Cerebroplacental ratio was abnormal in 14 patients out of 32 patients in FGR who had adverse perinatal outcome p-value of 0.001. The MPI was abnormal in adverse perinatal outcomes in 13 patients; a p-value of 0.9 was not considered significant. The DV-pulsatility index (PI) was abnormal in eight patients; a p-value of 0.7 was not considered significant. AoI Doppler was abnormal in six patients with a p-value of 0.9 and was not considered significant. Conclusion: We concluded that DV Doppler was the most useful parameter in the short-term prediction of perinatal mortality. The myocardial performance index may become abnormal earlier than ductus venous followed by AoI and are all associated with adverse perinatal outcomes. The CPR was also useful in deciding outcome measures such as emergency lower segment cesarean section (LSCS), and neonatal intensive care unit (NICU) admissions.