Diagnostic Accuracy of Umbilical Artery and Middle Cereberal Artery Doppler in Detection of Intrauterine Growth Restriction

Abstract

Objective: To determine the diagnostic accuracy of Umbilical Artery and Middle Cerebral Artery Doppler in detection of intrauterine growth restriction among pregnant women. Study Design: Descriptive Cross-Sectional Study. Place and Duration of Study: The Department of Gynecology and Obstetrics, Fauji Foundation Hospital, Rawalpindi, over a period of six months from May 2019 to October 2019. Materials and Methods: Study participants were 159 pregnant women presented to antenatal clinics. The inclusion criteria were gestational age more than 30 weeks with singleton pregnancies, sure last menstrual period, period of gestation confirmed by dating ultrasonography, small for dates or clinical suspicious of intrauterine growth restriction, and women who provided informed consent. Doppler scan was performed in all those women. Results: Mean age of all the enrolled women was 26.8 (± 6.6) years. Out of 159 women, 32 (20 percent) were nulliparous. On Doppler scan, 29 (18.2 percent) women had intrauterine growth restriction. The mean gestational age at the time of delivery was 35.3 (± 0.95) weeks. Caesarean section was performed in 131 (82.5 percent) of the deliveries. At birth, 24 (15.1 percent) had intrauterine growth restriction. The sensitivity, specificity, positive and negative predictive values of Doppler scan to detect intrauterine growth restriction were 83.3 percent, 93.3 percent, 69.0 percent, and 96.9 percent respectively. The diagnostic accuracy of Doppler scan was 91.8 percent. Conclusions: Our study shows a high sensitivity and specificity of Doppler scan in detecting intrauterine growth restriction.

Keywords

• intrauterine growth restriction, middle cerebral artery, pulsatility index, resistance index, umbilical artery