| Assessment of Pregnancy Outcome in IUGR Fetuses, Using the Doppler Flow Velocimetry of the Umbilical and Middle Cerebral Artery Authors. |
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Sung Nam Cho |
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| 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. |
| Key Words:
Intrauterine growth retardation, Doppler flow velocimetry, Neonatal outcome, Brain-sparing effect |
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