Doppler Ultrasound Abnormalities in Intrauterine Growth Restrictions
Zahid Nazir, Shamaila Hussain, Samina Raza, Muhammad Azam, Syed Waqas Ahmed
Background: Intrauterine growth restriction is the second most common and leading cause of perinatal morbidity and mortality after prematurity. It has substantial effects on fetal, neonatal life and later in adulthood. IUGR can be detected during pregnancy by using ultrasonography, which is a non-invasive and reliable tool. Different parameters on ultrasound can help to predict the IUGR.
Aim: To determine the abnormalities of Doppler ultrasound in pregnant females with intrauterine growth restricted fetus.
Methods: This cross sectional study was conducted in the Department of Radiology in collaboration with Department of Obstetrics & Gynecology, Kot Khawaja Saeed Teaching Hospital, KEMU Lahore from 1st August 2019 to 30th January 2020. Females of age 18-42 years, presenting at gestational age >32 weeks undergoing Doppler ultrasound for assessment of features of IUGR. All scans were done by a senior radiologist. Findings i.e., abdominal circumference, umbilical artery pulsatility index, cerebroplacental ratio, absent end-diastolic velocity and reversed end-diastolic velocity were recorded on proforma.
Results: In this study, we included 200 pregnant females with IUGR fetus. The mean age of females was 29.86±6.34 years. The mean BMI of females was 29.89±12.73kg/m2. The mean gestational age at presentation was 35.76±0.96 weeks. On Doppler ultrasound, abdominal circumference of fetus was 11.54±4.21cm, mean estimated fetal weight was 2021±105.96 grams, mean uterine artery pulsatility index was 96.23±24.56 and mean Cerebro-placental ratio was 0.98±0.13. Abnormal Doppler Uterine artery was observed in 83(41.5%) patients, middle cerebral artery was noted in 119(59.5%) patients, Absent/Reversed end diastolic flow was noted in 121(60.5%) patients while Cerebro-placental ratio <1 was noted in 127(63.5%) patients. Conclusion: Thus there is high rate of variation in Doppler parameters in IUGR fetuses. Thus changes in features of Doppler scan early in third trimester can help to predict the IUGR and IUGR can be prevented or managed on time in order to improve the outcome of pregnancy.
Keywords: Doppler ultrasound, intrauterine growth restriction, pulsatility index, abdominal circumference