ROLE OF COLOUR DOPPLER: CEREBRAL AND UMBILICAL ARTERIAL BLOOD FLOW VELOCITY IN NORMAL AND GROWTH RESTRICTED PREGNANCY

INTRODUCTION: Doppler velocimetry is a rapid noninvasive test that provides valuable information about haemodynamic situation of the foetus and is an efficient diagnostic test of foetal jeopardy which helps in timely intervention and management of high risk pregnancy for better perinatal outcome. OBJECTIVES: To evaluate middle cerebral artery and umbilical arterial velocity waveforms and their various indices during third trimester of pregnancy. METHODOLOGY: Prospective study including 50 women with normal singleton pregnancy and 50 women with intrauterine growth restricted pregnancy booked for regular antenatal checkups in our hospital. RESULTS: Foetal biometery i.e. EFW(estimated foetal weight), BPD (bi parietal diameter), HC(head circumference), AC(abdominal circumference) and FL(femur length) all the values were significantly reduced in IUGR pregnancy. Mean amniotic fluid index was significantly reduced for IUGR pregnancy. Umbilical artery indices were significantly raised in IUGR pregnancy. Mean Pulsatility index (PI) for study group was 1.03 +/- 0.22 as compared to control group of 0.87 +/- 0.17, P value being < 0.0003. Mean Resistance index (RI) for study group was 0.65 +/- 0.14 as compared to 0.58 +/- 0.06 for control group, P value being 0.0015. Mean Systolic diastolic ratio (S/D) for study group was 2.96 +/- 0.78 as compared to 2.43 +/- 0.32 for control group, P value being < 0.0001. Reduced mean middle cerebral artery indices in IUGR pregnancy. Cerebro umbilical ratio was significantly reduced in study group. AEDV was present in 12% of women in study group and REDV in 8% women of study group. IUGR pregnancies deliver early as in comparison to normal pregnancies. Significant numbers of babies having IUGR were delivery by LSCS. Mean birth weight is significantly reduced in control for study group. Similarly, significant number of babies in IUGR pregnancies requires NICU admission. Significant number of patients in study group has associated PIH. CONCLUSIONS: In normal pregnancy there is gestational age related fall in impedance in umbilical and middle cerebral arteries. Doppler study of umbilical and middle cerebral artery is highly sensitive in the detection of IUGR and prediction of adverse perinatal outcome in small for gestational age.