Assessment of Pregnancy Outcome in IUGR Fetuses, Using the Doppler Flow Velocimetry of the Umbilical and Middle Cerebral Artery Authors

Cho, Sung Nam

Abstract

OBJECTIVES
The purpose of this study in intrauterine growth retardation(IUGR) is to assess the relationship between the Doppler flow velocimetry and pregnancy outcome. STUDY DESIGN: 356 normal and 159 growth retarded fetuses between 21 and 42 gestati- onal weeks were investigated retrospectively. All IUGR fetuses were divided into four gro- ups according to the results obtained by Doppler flow velocities as follows. 1) Group 1(n= 89) : patients had normal umbilical artery resistance index ( Rlu ) and normal middle cerebral artery resistance index ( Rlmca ) 2 ) Group 2 ( n= 9 ) : patients had normal Rlu and abnormal Rlmca 3 ) Group 3 ( n=25 ) : patients had abnormal Rlu and normal Rlmca 4) Group 4 ( n=36 ) : patients had abnormal Rlu and abnormal Rlmca.
RESULTS
We obtained normal values of RIu and RImca in oriental. Abnormal cardiotoc- ography(CTG) findings and operative delivery for fetal distress were significantly increased in group 2(p < 0.05) and markedly increased in group 3 and 4 ( p < 0.01 ) compared with group 1. Adverse neonatal outcome was significantly increased in group 3 and 4 compared with group 1. There is significant increase of adverse neonatal outcome in group 4 compared with group 3 ( p < 0.05 ).
CONCLUSIONS
We obtained the normal values of Rlu, Rlmca and cerebroplacental ratio ( CPR ) in oriental. Adverse neonatal outcome was significantly increased in group 2, 3 and 4 compared with group 1. There is significant increase of adverse neonatal outcome in gr- oup 4 compared with group 3. We also found a strong correlation between the CPR and adverse neonatal outcome in IUGR. In IUGR, centralization of the fetal circulation turned out to exist, resulting in a preferential shunting of blood flow to the fetal brain. Brain-sp- aring effect with Doppler flow velocimetry could be demonstrated by this result.