Pradip Kumar Das 1 , Santanu Das 2 , Sampa Chakrabarti 3 1Consultant, Department of Radiology, Medicare Images, Asan
BACKGROUND Timely diagnosis of foetal compromise offers the best chance to reduce perinatal complications associated with IUGR. Intrauterine Growth Retardation (IUGR) is conveniently defined as foetal weight of less than 10th percentile for gestational age. IUGR is associated with many short-term complications like prematurity, necrotising enterocolitis, hypoxic ischaemic encephalopathy, intraventricular haemorrhage, etc. and long-term sequel like short stature and learning disabilities, etc. Perinatal mortality rates are 4-8 times higher for growth retarded infants and morbidity is present in 50% of surviving infants. It is therefore of utmost importance to recognise the condition as early as possible and intervene at a timely manner. MATERIALS AND METHODS In the present study, pregnancies of more than 24 weeks of gestational age with estimated foetal weight less than 10th percentile for gestational age were included. Doppler ultrasound on foetal MCA, UA and TA recorded the PI values obtained from each vessels and any End-Diastolic Flow (EDF) changes were obtained. Pregnancies were followed up and assessed the perinatal outcome in terms of gestational age at delivery, cesarean section for foetal distress, birth weight, admission to NICU and perinatal death. RESULTS The mean age of the mother was 26.02 years. On Doppler ultrasound study, 58% of the foetuses had some abnormality in the Doppler parameter. Cesarean section for foetal distress was significantly associated with REDF in TA (p <0.04). On the other hand, absent or reversed EDF (AEDF/REDF) in UA was significantly associated with perinatal death (p <0.01 for AEDF and p <0.001 for REDF). AEDF in UA had the highest OR of 3.04 for cesarean section. AEDF in UA had the highest OR of 10.75 for perinatal death, whereas the RR for perinatal death was highest for REDF in UA (RR = 22.50). CONCLUSION Foetuses with AEDF/REDF in TA are at increased risk of cesarean section for foetal distress and admission to NICU. Foetuses with REDF in the UA have the highest risk of perinatal death.
