Article

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

Behind KD Care Hospital, 314, Saket Nagar, Indore, 452 001 M.P, India
Journal of Obstetrics and Gynecology of India 01/2011; 61(2):166-171. DOI: 10.1007/s13224-011-0018-7

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.

ResultsMothers 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.

ConclusionGrowth 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.

Keywordsmiddle cerebral artery–umbilical artery–intrauterine growth restriction pulsatility index–doppler ultrasonography

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