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

Abstract

Abstract:The objective is study the role of fetal MCA-PSV for prediction of perinatal outcome in growth restricted fetuses. A Hospital based cohort study of 40 IUGR fetuses (gestation age 28-36 weeks, EFW < 10 th percentile, UA-PI >95 th percentile) in whom MCA-PSV values were obtained on three or more occasions from the time of admission till delivery depending upon period of gestation and severity of IUGR. MCA-PSV values were considered abnormal when they were above the 95 th percentile for MCA-PSV range. For analysis purpose two groups were made of twenty patients each depending upon MCA-PSV. All the fetuses (100%) in group B (i.e. with abnormal MCA-PSV) had adverse perinatal outcome in the form of either mortality (both IUFD and neonatal mortality) or major neonatal complication consisting of NICU stay ≥ 14 days, requirement of artificial ventilation or presence of intraventricular hemorrhage, respiratory distress or sepsis. Specificity of abnormal MCA-PSV was found to be 100% in predicting adverse perinatal outcome. Doppler study of MCA-PSV should be used in the surveillance of IUGR fetuses together with currently used Doppler parameters so as to decide the optimal time for delivery permitting maximum maturity with minimal fetal hypoxia or acidosis and hence optimizing fetal outcome.