Uterine artery Doppler analysis at 11-14 weeks as a predictor of intra-uterine growth restriction

Uttara Gupta, Usha Agrawal


Background: Successful pregnancy results from reciprocity between placental and maternal cardiovascular system. Intra-uterine growth restriction (IUGR) is a condition which arises from insufficiency of placenta and can be seen as variations in waveforms in uterine artery (UtA). In our study, we studied, whether predictive accuracy of various UtA Doppler indices for IUGR in first trimester early enough to provide an intervention for prevention of IUGR, as it was a leading cause of neonatal morbidity and mortality.

Methods: The study design was a prospective observational study. UtA Doppler was done at 11-14 weeks in 120 pregnancies attending the outpatient and inpatient department of obstetrics and gynaecology, PCMS, Bhopal. The left and right UtA velocity waveforms were studied. Mean pulsatility index (PI), mean resistive index (RI) and diastolic notch were noted. Results obtained were analyzed and tabulated.

Results: Amongst these, 25.86% developed IUGR. First trimester UtA mean RI and PI were remarkably elevated in patients who developed IUGR on follow up. No relationship was noted between diastolic notch and IUGR. Mean RI and PI were found to be good predictors of IUGR. Using receiver operating characteristics (ROC) curve, the best cut-off of mean RI and mean PI to detect IUGR was 0.68 and 1.56 respectively.

Conclusions: UtA Doppler at 11-14 weeks of gestation recognizes a huge proportion of women who will develop IUGR.



Uterine artery Doppler, IUGR, Pulsatility index, Resistance index

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