Analysis of Doppler Criteria in the Diagnosis of IUGR

Introduction: The assessment of the Doppler velocimetric indices of the uterine, umbilical and middle cerebral artery helps in diagnosing and monitoring pregnancies with fetal growth disorder.
Material and method: Two groups were studied: the 1st group SGA (small for gestational age) including 22 fetuses whose birth weight was below the 10th percentile for gestational age and the 2nd group AGA (appropriate for gestational age) comprising 58 fetuses whose birth weight was between the 10th and 90th percentile. According to Doppler changes we could identify fetuses with intra uterine growth restriction (IUGR) and perform a comparative analysis of Doppler changes according to frequency and also assessed the predictive accuracy of some abnormal velocimetric indices for diagnosing SGA.
Results: In the SGA group we found 8 fetuses with IUGR (36.3%), based on the fetal brain-sparing phenomenon indicated by Doppler changes. In the AGA group Doppler changes were observed in only 1 pregnancy (1.7%). The frequency of Doppler changes was significantly higher in the SGA group. The highest predictive accuracy for SGA was found for a cerebroplacental ratio (CPR) below 1.08 (88.89% PPV; 80.28% NPV; 36.36% Se and 98.28% Sp) with p <0.0001.
Conclusions: Many cases of IUGR occur in pregnancies without evident risk factors as shown in this study. The most effective parameter for diagnosing SGA was found to be the CPR below 1.08.