Middle cerebral artery Doppler indices better predictor for fetal outcome in IUGR

Abstract

:Objective(s) : To compare the role of middle cerebral artery and umbilical artery Doppler pulsatility indices in predicting the fetal outcome in intrauterine growth restriction. Method(s) : The prospective study was conducted on 121 subjects. They were divided into two groups. The study group (n=71) consists of high risk group of pregnant women with growth restricted fetuses. The control group (n=50) consists of pregnant women with healthy fetuses. Both the groups were evaluated by middle cerebral artery and umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Results : Mothers with abnormal velocimetry had more number of cesarean sections to prevent fetal distress than those with normal velocimetry. The subjects with high risk factors had more number of abnormal waveforms than those without high risk factors. The predictive value of Doppler P.I for detecting abnormal fetal outcome was 94% in middle cerebral artery as against 83% for umbilical artery. The sensitivity was 71% for middle cerebral artery versus 44% for umbilical artery. Conclusion : Growth restricted fetuses with normal flow velocimetry are at a lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower as compared to that of neonates with normal velocimetry. Thus middle cerebral artery doppler indices were a better predictor for fetal outcome in IUGR when compared with umbilical artery in terms of sensitivity and predictive value.

Middle Cerebral Artery Peak Systolic Velocity as a Predictor of Perinatal Outcome in Fetal Growth Restriction

“…9.37 days (p-value<0.05). Our findings are in accordance with the study of Hemlata D et al [1] in which neonates with abnormal MCA Doppler were more than twice is likely to be admitted in neonatal intensive care unit that the neonates with normal Doppler waveforms.…”

“…Umbilical artery and middle cerebral artery are the most frequently studied vessels and are good predictor of growth restricted fetuses at risk of antenatal compromise [1].…”

Comparison of Diagnostic Efficacy of Umbilical Artery and Middle Cerebral Artery Waveform with Color Doppler Study for Detection of Intrauterine Growth Restriction

“…In a similar design, Dhand et al [5] observed a sensitivity and specificity of 44 and 61.5 %, respectively, in prediction of the IUGR outcome. The positive and negative predictive values in their study were in 83 and 20 %, respectively.…”

Utility of doppler derived middle cerebral artery: peak systolic velocity and pulsatility index in prediction of perinatal outcomes of IUGR pregnancies

“…Nalini Y et al found that 35%cases with abnormal Umbilical artery and Middle cerebral artery Doppler waveforms required NICU admission. 12,13 Changes in MCA-PI were not as consistent as those of MCA-PSV. MCA-PI was normal in 5 patients with abnormal PSV which finally had adverse perinatal outcome.…”