Role of colour doppler indices in diagnosing intrauterine growth restriction in high risk pregnancies in second and third trimester

Abstract

Background: Intrauterine growth restriction (IUGR) is associated with impaired neurological development of child, increased morbidity and increased risk of death during perinatal period. Doppler ultrasound during pregnancy is a useful tool for early detection of IUGR and this helps in early management to prevent further complications associated with IUGR.
Objective: To study efficacy of color doppler in diagnosing Intrauterine growth restriction in high risk pregnancies in second and third trimester.
Materials and Methods: Diagnostic efficacy study was conducted among 100 subjects with high risk pregnancy presenting in second and third trimester. IUGR was suspected when there was a growth lag of >4 weeks between gestational age and fundal height. Further two-dimensional ultrasound was performed. Bi-parietal diameter, Head circumference, Abdominal circumference, Femur length were noted, estimated fetal weight was calculated. IUGR fetuses were identified if abdominal circumference is<5> Results: Majority were of 22-25 years (52.5%); 53.75% were primigravida; 41.25% presented at 33-37 weeks; 46.25% had gestational hypertension. The overall sensitivity of doppler indices as seen in the present study was good (89.9%) but specificity was only 9.1%. Among the other indices, CPR had the best diagnostic utility with sensitivity=64%; specificity=100% and PPV=100% followed by umbilical artery doppler with sensitivity=55.1%; specificity=81.8% and PPV=96.1%.
Conclusion: The overall color doppler indices are highly sensitive in detection of IUGR and lacks the specificity. CPR and Umbilical artery doppler can be used with more reliability.