Publication:

A study of various fetal Doppler indices to assess outcome in growth restricted fetuses: a comparative and cross-sectional study

Background Fetal growth restriction (FGR) poses significant risks of adverse perinatal outcomes. Accurate surveillance is essential to distinguish pathologically growth-restricted fetuses from constitutionally small infants and to optimize the timing of delivery.

Methods A comparative cross-sectional observational study was conducted at Rajiv Gandhi Medical College among 118 singleton pregnancies (≥32 weeks) with diagnosed FGR. Comprehensive doppler velocimetry of the umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) was performed and categorized into doppler grades 0 to 5. Primary outcomes evaluated were perinatal morbidity, neonatal mortality, APGAR scores, and birth weight.

Results Normal doppler (grade 0) was present in 98 (83.1%) participants, while 20 (16.9%) exhibited abnormal doppler indices. Abnormalities in UA, MCA, and DV were strongly associated with adverse outcomes (p<0.001). Grade 0 doppler showed a high association with normal neonatal outcomes (odds ratio=24.14, p<0.001). Conversely, severe doppler deterioration (grade 4 and grade 5) was significantly associated with perinatal morbidity (p=0.037) and neonatal mortality (p=0.011), respectively. Infants with abnormal doppler had significantly lower gestational age at delivery (35.35±2.30 vs 37.22±0.58 weeks, p=0.001), lower APGAR scores at 5 minutes (6.10±3.09 vs 8.53±0.61, p<0.001), and reduced birth weights (1.67±0.44 kg vs 2.09±0.14 kg, p<0.001).

Conclusions Fetal doppler surveillance effectively stratifies risk in growth-restricted fetuses. Abnormal doppler indices correlate strongly with hemodynamic compromise and adverse perinatal outcomes, providing critical evidence to guide timely clinical intervention prior to irreversible fetal acidemia.