Monisha, K (2022) Study of Umbilical Artery, Middle Cerebral Artery and Fetal Aortic Isthmus Doppler in Intrauterine Growth Restriction and Its Perinatal Outcome at a Tertiary Care Hospital in Chennai: A Prospective study. Masters thesis, Stanley Medical College, Chennai.
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Abstract
AIM OF THE STUDY: • Role of umbilical artery, middle cerebral artery, and fetal aortic isthumus waveforms in predicting adverse pregnancy outcomes in clinically suspected IUGR and the role of doppler velocimetry in clinical management of such pregnancies. OBJECTIVES: 1. To analyse the blood flow in fetal aortic isthumus, umbilical artery middle cerebral artery, in a group of patients with clinically suspected high risk pregnancies 2. To assess the value of Doppler ultrasound in analyzing PERINATAL OUTCOME in patients with clinically suspected high risk pregnancies. Study center: Govt. RSRM Lying in Hospital, Chennai. Duration of Study: November 2020 to December 2021 Study Design: Prospective study. METHODOLOGY: This study will be conducted on 200 women with high risk pregnancies within inclusion criteria admitted to Govt. RSRM Lying in hospital, Chennai. A routine history taking, general examination, obstetric examination will be done. Patients will be explained about the atraumatic nature of the investigation and informed written consent will be obtained. Synthetic ultrasound gel will be applied over the abdomen to get good accoustic coupling. The instrument used will be a mindray colour Doppler ultrasound machine with a convex transducer 2 t 5 mhz frequency. Doppler wave form will be obtained after localising the vessels by B mode real time scanner. Pulsed Doppler will be used to get the Doppler signals after localising the vessels. The maximum Doppler shift frequencies were obtained and various ratios will be calculated from each vessel. Doppler examination will be done when fetus is in apneic state to avoid influence of fetal respiration on doppler signals The gestational Age will be based on the LMP ,Ultrasound biometry performed before 20th week if LMP is uncertain. Follow up Doppler studies will be conducted if clinically indicated or in case of worsening Doppler indices. Inclusion criteria: All antenatal cases more than 30 weeks of gestation singleton pregnancies, clinically diagnosed as the following are included. IUGR (EFW <10TH percentile for gestational age). Those who gave consent for the study. The gestational Age will be based on the LMP, Ultrasound biometry performed before 20th week if LMP is uncertain. Exclusion criteria: The following pregnancies were excluded. Cardiovascular disease, Multiple gestation, Fetus with congenital anomalies, Renal disease, Essential hypertension prior to pregnancy, Intrauterine death at the time of first doppler examination. Sample size: 200. CONCLUSION: • The present study noted an adverse fetal outcome in cases of severe preeclampsia and or IUGR which showed abnormal Doppler results. • The finding of REDF is ominous and AEDF also correlated with poor fetal outcome with a perinatal mortality of 60%. • In our study AIEDF had the highest sensitivity of 100% in predicting adverse fetal outcomes. • Because CPR incorporates data not only on the placental side but also the fetal response it can be considered potentially more advantageous. • Doppler patterns follow a longitudinal trend with early changes in the umbilical artery followed by middle cerebral artery. • Doppler investigation of the fetal circulation plays an important role in monitoring the redistributing fetus and thereby may help to determine the optimal time for delivery. • Doppler serves as an important yardstick for the obstetricians when dealing with pregnancies complicated with preeclampsia and growth restriction.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221916060 |
| Uncontrolled Keywords: | Umbilical Artery, Middle Cerebral Artery, Fetal Aortic Isthmus Doppler, Intrauterine Growth Restriction, Perinatal Outcome, Tertiary Care Hospital, Chennai. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology > MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 03 May 2021 09:43 |
| Last Modified: | 03 Dec 2023 05:21 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15707 |
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