Predictive Accuracy of Doppler SystolicDiastolic Ratio of Umbilical Artery for Evaluation of IUGR in 3rd Trimester

Predictive Accuracy of Doppler SystolicDiastolic Ratio

Abstract

Intrauterine Growth Restriction (IUGR) is an important multifactorial obstetric and neonatal problem worldwide especially in Pakistan. It is defined as failure of the fetus to achieve its genetically predetermined growth potential and has sonographic estimated fetal weight below 10th percentile for that particular gestational age. IUGR fetus has abnormal sonographic fetal biometry and Doppler parameters.

 Objective: To determine the predictive accuracy of doppler Systolic/Diastolic ratio of Umbilical Artery for Evaluation of IUGR in 3rd trimester

 Methods: A cross-sectional (predictive) study was conducted in Clinical Radiology Department of University of Lahore (UOL) teaching Hospital Lahore. Total 70 singleton pregnant women, among them 35 normotensive pregnant women in control group and 35 hypertensive pregnant women in study group, in 3rd trimester were recruited. Sonographic fetal biometry was done and Systolic/Diastolic (S/D) Ratio of Umbilical Artery (UA) Doppler was measured for evaluation of IUGR fetuses.

 Results: Systolic/Diastolic (S/D) Ratio of Umbilical Artery Doppler showed sensitivity 85.71%, specificity 80%, Positive predictive value (PPV) 81.08%, and Negative predictive value (NPV) 84.85 % and diagnostic accuracy 82.86%, when S/D Ratio 2 3 was considered abnormal for evaluation of IUGR in pregnancy induced hypertension (PIH).

 Conclusion: Measurement of Umbilical Artery Doppler Systolic/Diastolic Ratio for investigation of fetal circulation is a valuable predictor for evaluation of IUGR. Hence it may be used along with conventional sonographic fetal biometry in surveillance of fetal growth and wellbeing in 3rd trimester of pregnancy.