A Umbilical Artery Doppler Velocimetry as A Diagnostic Tool for Foetal Growth Restriction Among Women with High-Risk Pregnancy in Jos, North Central Nigeria.

Abstract

Abstract

Background: Fetal growth is a common challenge among high-risk pregnancies as a result of placental insufficiency. Current evidence shows that umbilical artery Doppler velocimetry is the clinical standard for distinguish between IUGR and SGA.

Objective-To determine the prevalence of IUGR among SGA fetuses in women with high-risk pregnancies using umbilical artery Doppler velocimetry

Design: It was a Hospital based prospective study.

Methods and Materials

This was a prospective study conducted from 1^st February, 2021 to 31^st January, 2022. A total of 161 women with high-risk pregnancies between 28 weeks and 38 weeks of gestation were recruited. A convenience sampling method was used, and interviewer-administered semi-structured questionnaire was administered. Data on socio demographic characteristics, obstetric history, LMP, gestational age, previous history of contraceptive use, irregular menstrual periods, and co-morbidities were obtained. The ultrasound was performed by a single investigator using 3.5MHz convex probe of GE Voluson P8 4D ultrasound machine. The fetal biometric parameters were measured in 2D mode before the Doppler mode was activated for the velocimetry of the umbilical artery. Fetuses with EFW below the 10^th percentile for their GA were adjudged SGA, while those with abnormal umbilical Doppler in addition were tagged growth restricted (IUGR). The data was analysed using SPSS software version 20.

Results: The prevalence of SGA and IUGR in this study was 19.9% (32) and 17.4% (28) respectively. All the 28 IUGR fetuses were among SGA fetuses, giving a prevalence of 87.5%. This was statistically significant (p ≤ 0.0001).  Majority (69.2%) of the IUGR were among women with pre-eclampsia. This was also statistically significant (p ≤ 0.0001).  Majority (89.3%) of the IUGR fetuses had reduced umbilical artery Doppler velocimetry.

Conclusion: Umbilical artery Doppler is a useful antenatal surveillance tool in women with high-risk pregnancies. Majority of SGA fetuses in women with high-risk pregnancies are growth restricted. Umbilical artery Doppler should be a routine practice in high-risk pregnancies complicated by fetal growth challenges.

Keywords: Umbilical artery Doppler Velocimetry, Fetal surveillance, SGA, IUGR, High-risk pregnancy