Prognostic value of obstetric Doppler ultrasound in fetuses with fetal growth restriction: an observational study in a tertiary care hospital.

OBJECTIVE

To determine the prognostic value of umbilical artery Doppler (UAD) with fetal growth restriction (FGR) and their perinatal outcomes.

METHODS

This was a retrospective cohort study of fetuses with growth≤5th centile from 2001 to 2012. Pregnancy outcomes were compared according to UAD findings for 253 cases. Doppler findings were categorized as; Normal End Diastolic Flow (NEDF), Reduced End Diastolic Flow (REDF) and Absent/Reverse End Diastolic Flow (AREDF). Mean and proportion were calculated and odds of perinatal complications were compared by using logistic regression for REDF and AREDF with NEDF at 5% level of significance.

RESULTS

The perinatal morality rate was 3.2%. Neonates with abnormal Doppler were at increased risk of cesarean delivery, low birth weights and low Apgar scores. Among the perinatal morbidity, neonatal intensive care unit (NICU) admission was 4.2 and 15.3 times in neonates with REDF and AREDF and similarly the perinatal mortality of AREDF was 12.5 times higher as compared to NEDF. Other morbidities were also much higher in abnormal Doppler groups.

CONCLUSION

There is a prognostic value of UAD in predicting the outcomes for FGR fetuses and therefore recommend its use in the conservative management of such pregnancies to reduce perinatal mortality and morbidity.