Screening tests for intrauterine growth retardation:  a comparison of umbilical artery Doppler to real-time ultrasound.
In a study designed to compare Doppler umbilical artery velocimetry to ultrasound morphometric measurements in the prediction of intrauterine growth retardation, 636 paired ultrasound and Doppler umbilical artery examinations were performed between 24 and 40 weeks gestational age. Intrauterine growth retardation was defined as birth weight less than the tenth percentile per gestational age and 25 (9.2%) of the infants born in our study met this criteria.  In general, when the gestational age was limited to less than 30 weeks, none of the tests were highly predictive of intrauterine growth retardation.  Doppler umbilical artery systolic-to-diastolic ratios of greater than 3 had the highest sensitivity. However, due to inclusion of a large number of false-positives, it was considered a poor test.  After 30 weeks, fetal abdominal circumference less than the tenth percentile had a greater sensitivity (45%) and positive predictive value (28%) than Doppler systolic-to-diastolic ratios greater than 3 (36% and 18%, respectively).  Doppler ultrasound umbilical artery systolic-to-diastolic ratios are not more predictive of intrauterine growth retardation than ultrasound morphometric measurements.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham 35294.
C L
CL
Lowery
R L
RL
Goldenberg
R C
RC
Baker
R
R
Mehta
J
J
Wan
R O
RO
Davis
C G
CG
Brumfield
H J
HJ
Hoffman
D001724:Birth Weight; D001783:Blood Flow Velocity; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000379:methods*; D014469:Umbilical Arteries / Q000502:physiology