Perinatal Outcome in Growth Restricted Fetuses in A Tertiary Care Hospital of North India
Perinatal Outcome in Growth Restricted Fetuses in A Tertiary Care Hospital of North India
DOI:
https://doi.org/10.70284/njirm.v8i3.1237Keywords:
fetal doppler, fetal growth restriction, intrauterine growth restriction, low birth weight, Perinatal outcome, small for gestationAbstract
Background: Fetal growth restriction refers to a fetus that has failed to achieve its genetically determined growth potential and is associated with an increased perinatal mortality and morbidity. Objectives: To observe the outcome of the fetal growth restricted fetuses diagnosed at or more than 26 weeks of gestation in a tertiary care hospital of North India. Settings and design: prospective observational study. Methods: The study was conducted on 96 antenatal women diagnosed with foetal growth restriction at/after 26 weeks of gestation who were managed conservatively depending on the ultrasonographic doppler findings and maternal disease over a period of one year. Pregnancy outcome was observed and statistically analysed. Results: 91% women were booked and 60% were between 34 weeks to 40 completed weeks of gestation depicting a late onset foetal growth restriction. Preeclampsia was the most common indication of admission (44.79%). Abnormal doppler findings were observed in 85.4% women; the maximally affected (83.3%) foetal vessel was the umbilical artery. 82.29% women delivered by cesarean section. Adverse perinatal outcome was observed in 55.2% neonates. Maximum perinatal mortality rate (46.15%) was observed in 26- 30 weeks of gestation. Conclusions: Fetal growth restriction (FGR) is associated with an increased perinatal mortality and morbidity. Accurate and timely detection of FGR, good antenatal and neonatal care can improve the perinatal outcome of growth restricted fetuses to some extent. [Shweta G NJIRM 2017; 8(3):17-21]
References
2. ACOG Practice bulletin no. 134: fetal growth restriction. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2013 May;121(5):1122-33.
3. Baschat AA, Gembruch U, Reiss I, Garner L, CP Weiner, Harman CR. Relationship between arterialand venous Doppler and perinatal outcome in Foetal growth restriction. Ultrasound Obstet Gynaecol 2000;6:407-13.
4. Reece EA, Goldstein I, Hobbins JC (eds). Fundamentals of Obstetric & Gynecologic Ultrasound. Norwalk, CT: Appleton & Lange. 1994: 15–26.
5. Tekay A, Campbell S. Doppler ultrasonography in Obstetrics and Gynaecology 4th edn; Callen PW; WB Saunders Company. 2000:677-718.
6. Lubchenco LO, Hansman C, Boyd E. Intrauterine growth as estimated from live born birth weight data at 24-42 weeks of gestation. Paediatrics 1963; 32:793.
7. Grannum, P.A., Berkowitz, R.L. Hobbins, J.C. The ultrasonic changes in the maturing placenta and their relation to fetal pulmonic maturity. Am J Obstet Gynecol 1979; 133(8): 915-922.
8. Madazli R, Sen C, Uludag S, Ocak V. Prognostic factors for survival of growth restricted fetuses with absent end diastolic velocity in the umbilical artery. J Perinatology 2002;22:286-90.
9. Arora D, Desai S, Seth PN, Kania P. Significance of umbilical artery velocimetry in perinatal outcome of growth restricted foetuses. J Obstet Gynecol India 2005;55(2): 138-43.
10. Mills TA, Wareing M, Buggs GJ, Greenwood SL, Backer PN. Chorionic plate artery function and Doppler indices in normal pregnancy and intra uterine growth restriction. Eur J Clin Invest 2005;35:758-64.
11. Danish N, Fawad A, Abbasi N. Assessment of pregnancy outcome in primigravida: comparison between booked and unbooked patients. J Ayub Med Coll Abottabad 2010: 22(2):23-5.
12. Deshmukh A, Soni N, Gokhale S. Significance of umbilical artery Doppler velocimetry in the perinatal outcome of growth restricted fetuses. J Obstet Gynecol 2010;60(1): 38-43.
13. Coleman MA, McCowen LM, North RA. Mid trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high-risk women. Ultrasound Obstet Gynecol 2000:15(1):4-6.
14. Manning FA, Platt LD, Sipos L. Antepartum foetal evaluation: Development of a foetal biophysical profile. Am J Obstet Gynecol 1980;136:787-95.
15. Dudley NJ, Fagan DG and Lamb MP. Ultrasonographic placental grade and thickness: associated with early delivery and low birth weight. BJR 1993;66:175-7.
16. Fleischer A, Schulman H, Farmakides G, Bracero L, Grunfeld L, Rochelson B et al. Uterine and umbilical artery Doppler velocimetry in pregnant women with hypertension. Am J Obstet Gynecol 1986;154:806-13.
17. Visentin S, Cavallin F, Zanardo V, Cosmi E. Neonatal outcome in intrauterine growth restricted and small for gestational age fetuses. Ultrasound Obstet Gynecol 2010;36(1):52-67.
18. Mazarico E, Roig Gomez M, Sabria J, Ancel Martin A, Vela A, Lailla J. Perinatal outcomes in gestations with intrauterine growth restriction and small for gestational age foetuses. Ultrasound Obstet Gynecol 2010;36(1):152-167.
19. Holmqvist P, Ingemarsson E, Ingemarsson I. Intrauterine growth retardation and gestational age: Acta Obstet and Gynecol Scand 1986;65:633-38.
20. Mallikarjunappa B, Harish H, Ashish SR. Doppler changes in preeclampsia. JIMSA 2013;26(4):215-16.
21. Deshmukh A, Soni N, Gokhale S. Significance of umbilical artery Doppler velocimetry in the perinatal outcome of growth restricted fetuses. J Obstet Gynecol 2010;60(1): 38-43.
22. Seyam YS, Al-Mahmeid MS, Al-Tamimi HK. Umbilical artery Doppler flow velocimetry in intrauterine growth restriction and its relation to perinatal outcome. Int J Obstet Gynecol 2002;77:131-37.
23. McCowen LM, Harding JE, Roberts AB. A pilot randomized controlled trial of two regimes of foetal surveillance for small for gestational age foetuses with abnormal umbilical artery Doppler. Ultrasound Obstet Gynecol 2002;19:225-8.
