Tag Archives: IUGR

Eco Doppler Examination in Pregnancies with Fetal Growth Restriction

Fetal growth restriction remains a major cause of perinatal morbidity and mortality in modern obstetric practice. Doppler velocimetry provides a wide array of information on maternal, fetal, and placental aspects of intrauterine growth restriction (IUGR). Delivery is the only practical treatment option, and the timing of delivery must be aimed to maximize gestation while minimizing the risks of continued intrauterine life. The investigation of the fetal circulation using eco Doppler ultrasonography has become more sophisticated, with greater attention being played to the venous circulation, particularly that unique to the fetus: ductus venosus and the umbilical vein.

Full text: PDF

Ultrasound and Doppler Assessment of Fetuses with Growth Restriction in the Absence of an Evident Etiological Factor

Background: Differentiation between normal and pathological fetal growth may be difficult and a regular fetal biometry is required, with ultrasound examination of the placenta, amniotic fluid index assessment and Doppler velocimetry of pregnancies with fetal growth disorders, even in the absence of a clear etiologic factor.
Material and method: This is an observational study and includes two groups: one with 24 pregnancies with FGR confirmed postpartum (SGA+) and another with 42 pregnancies with normal birth weight (SGA-). The database contained personal data, several parameters of fetal biometry, amniotic fluid index, placentation and velocimetric indices, birth-related data. Statistical analysis of obtained data was carried out using Microsoft Excel and Graphpad Prisma programs. We used the Student test, Z test and Chi square test and Fisher when needed. P <0.05 was considered statistically significant. We also used Pearson correlation index.
Results: Between the two groups there were statistically significant differences regarding fetal biometry parameters, especially AC and ultrasound estimated weight and birth weight, infant length, Apgar score at 5′ and days of hospitalization. Velocimetric indices were significantly higher in placental uterine and umbilical artery in SGA+ group. There was a negative correlation between umbilical RI and AFI in SGA+ group but without statistical significance.
Conclusions: Fetal biometry, umbilical artery Doppler examination (when RI <0.6) and AFI calculation (>10) are the most used methods in the assessment of normal fetal growth and intrauterine fetal wellbeing.

Full text: PDF

Analysis of Doppler Criteria in the Diagnosis of IUGR

DOI: 10.2478/amma-2013-0030

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.

Full text: PDF