Adi Weintraub

Background: To evaluate the role of umbilical artery (UA) peak systolic velocity (PSV) measurements in the prediction of perinatal outcome in fetuses with intrauterine growth restriction (IUGR). Methods: A prospective study was performed, including patients with a suspected diagnosis of IUGR. Exclusion criteria were multiple gestations, unreliable gestational age, and known fetal malformations. Doppler measurements of the UA and middle cerebral artery (MCA) were recorded. Results: Seventy-two patients were enrolled and a total of 192 Doppler measurements were performed between 24 and 39 weeks' gestation. Mean gestational age at delivery was 36.9±2.7 days and mean birth weight was 2,166±497 grams. Nine patients (12.5%) had oligohydramnios; 50 (69.4%) delivered preterm (<37 weeks), and 26 underwent a cesarean section, of those 7 (29.2%) cesarean sections were for a nonreassuring fetal heart rate tracing. Fifty-one (70.8%) neonates were actually small for gestational age. No correlation was found between UA-PSV and MCA-PSV to perinatal outcome. Correlation was found between UA pulsatility index and cerebroplacental ratio to perinatal outcome before 34 weeks' gestation. Conclusions: UA PSV measurements do not correlate with adverse perinatal outcome. A correlation exists between UA pulsatility index and cerebroplacental ratio and perinatal outcome prior to 34 weeks' gestation. It seems that UA PSV and MCA PSV do not contribute to the management of fetuses with IUGR.