| Abstract |
Objective: To determine the diagnostic performance of fetal Middle cerebral artery (MCA) – Peak Systolic velocity (PSV) for prediction of adverse perinatal outcome in Intauterine growth restriction (IUGR) fetuses and to determine the longitudinal trends in MCA-PSV in IUGR fetuses. Methods: Hospital based cohort study of 40 IUGR fetuses (gestation age 28-36 weeks, Estimated Fetal Weight (EFW)< 10th percentile, Umbilical artery-Pulsatility index (UA-PI>95th percentile) in whom MCA-PSV values were obtained on three or more occasions from the time of admission till delivery depending upon period of gestation and severity of IUGR. MCA-PSV values were considered abnormal when they were above the 95th percentile for MCA-PSV range. For analysis purpose two groups were made of twenty patients each depending upon MCA-PSV. Results: All the fetuses (100%) in group B (i.e. with abnormal MCA-PSV) had adverse perinatal outcome in the form of either mortality or major neonatal complication consisting of Newborn Intensive Care unit (NICU) stay ≥ 14 days, requirement of artificial ventilation or presence of intraventricular hemorrhage, respiratory distress or sepsis. Sensitivity &Specificity of abnormal MCA-PSV in predicting adverse perinatal outcome was found to be 90.91% & 100%. When followed longitudinally, in the three fetuses having fetal death, the PSV showed an initial increase in velocity followed by a fall prior to demise, thus suggesting that it could be a pre-terminal event. Conclusion: Fetal MCA-PSV appears to be a reliable indicator of adverse perinatal outcome in growth restricted fetuses with high sensitivity & specificity.
KEYWORDS: IUGR, MCA-PSV, Neonatal-outcome, IUD & NICU stay.
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