Comparative study of ductus venosus doppler versus umbilical artery doppler in Management of intra uterine growth restriction and perinatal outcome
International Journal of Development Research
Comparative study of ductus venosus doppler versus umbilical artery doppler in Management of intra uterine growth restriction and perinatal outcome
Received 11th April, 2018; Received in revised form 20th May, 2018; Accepted 21th June, 2018; Published online 30th July, 2018
Copyright © 2018, Sambhunath Bandyopadhyay et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Current challenges in the clinical management of IUGR include accurate diagnosis of the truly growth restricted fetus, selection of appropriate fetal surveillance and optimizing the timing of delivery. This study was conducted to evaluate the role of umbilical artery Doppler and ductusvenosus Doppler in management of IUGR pregnancy and perinatal outcome. Total 80 patients who were presented to the in-patient and out-patient department of obstetrics and gynecology of SSKM and IPGME&R Hospital between 28-36 weeks POG with IUGR pregnancy were included in the present study. They were evaluated with umbilical artery Doppler and ductusvenosus Doppler indices such as S/D ratio, PI and RI value. IUGR were detected by EFW <10th centile for the gestational age, and 7 patients, 68 patients and 55 patients were included in 28weeks, 32 weeks and 36 weeks respectively. Only 7 patients with IUGR were included at 28weeks after exclusion of congenital anomalies. Consequently they were followed up and new patients also added in 32 weeks, and patients number was 68 and at 36 weeks the patients had delivered earlier were excluded and number were 55. The mean gestational age at termination was 35.2554 weeks. The mean SFH was 30.4325. In this study 51.3% were PIH, 12.5% were heart disease and 5% was with typeII DM or GDM with vasculopathy. Cut off level of S/D ratio, PI value and RI values were taken as >95th percentile of normal range for the gestation. The study shows comparative predictive values of umbilical artery Doppler indices such as S/D ratio and PI values at 28 weeks and 36 weeks were more significant than ductusvenosus Doppler indices such as S/D ratio and PI values. As there is progressive deceleration in growth velocity and abnormal feto-placental Doppler patterns in IUGR associated with placental insufficiency, ductusvenosus Doppler and umbilical artery Doppler were used to evaluate IUGR pregnancy outcome, mode of delivery and perinatal outcome.