Doppler velocimetric indices from the abdominal and placental ends of the umbilical artery of growth-restricted fetuses

Purpose. In normal pregnancies, as gestation advances, a progressive decrease is observed in the difference between Doppler indices recorded at the 2 extremities of the umbilical cord. The purpose of this study was to determine whether the same pattern is observed in pregnancies complicated by intrauterine growth restriction (IUGR). Methods. Forty-seven fetuses with a sonographic diagnosis of IUGR underwent investigation by Doppler sonography. Blood flow velocities were measured at the abdominal and placental ends of the umbilical cord. The systolic-diastolic ratio, pulsatility index, and resistance index were calculated for each site. The differences in values between the 2 ends of the cord were calculated (abdominal end minus placental end) and then compared with the differences calculated for normal fetuses. Results. In contrast to normal fetuses, IUGR fetuses with abnormal Doppler measurements had significant differences in the pulsatility and resistance indices between the 2 ends of the cord after 28 weeks of gestation. In addition, when compared with normal fetuses, the IUGR fetuses had a significantly greater difference in the values for the 2 ends of the cord for all indices. Conclusions. These results emphasize the importance of identifying the sampling site for serial Doppler investigations in IUGR-complicated pregnancies. (C) 1997 John Wiley & Sons, Inc.