THE ROLE OF UMBILICAL ARTERY DOPPLER IN DETECTION AND MANAGEMENT OF FETAL GROWTH RETARDATION

The objective of this study was to evaluate the efficacy of Doppler flow study in the umbilical artery in the diagnosis and management of FGR (foetal growth retardation) in small for gestational age (SGA) fetuses. This descriptive study, was carried out in the Department of Obstetrics of Military Hospital Rawalpindi, in collaboration with the Radiology department. The data was collected from Jan 2000 to Dec 2001. Seventy subjects with SGA pregnancies on clinical examination were evaluated for foetal growth retardation. On the basis of umbilical artery doppler flow study the subjects were categorized into normal and abnormal umbilical artery doppler groups. Perinatal outcome of these groups were compared. Out of all SGA foetuses 28 (40%) were found to have abnormal umbilical artery doppler. They were more likely to be delivered by caesarean section (82.1%) and were born more than two weeks earlier. They had poorer Apgar score, higher rate of birth asphyxia (10.7%), hypoglycemia (46%), were twice as likely to be admitted to the newborn nursery (75%) and spent longer in the hospital (68% 48 hrs) and were smaller in all body proportions than those with normal umbilical artery doppler. There were five perinatal deaths (17.8%), all in babies with abnormal umbilical artery doppler. It is thus concluded that the doppler study allows a noninvasive assessment of uteroplacental insufficiency, and is an accurate method for diagnosis and management of foetal growth retardation