Outcome of small-for-gestational-age fetuses according to umbilical artery Doppler: is there any yield from additional middle cerebral artery Doppler?
OBJECTIVE
To investigate the outcome of small-for-gestational-age (SGA) fetuses in relation to the features of umbilical artery (UA) Doppler and to explore the prognosticator of middle cerebral artery (MCA) Doppler in SGA fetuses with normal UA impedance.


METHODS
Two hundred ninety-seven patients were classified into Group 1 with normal UA and MCA pulsatility index (PI), Group 2 with normal UA but abnormal MCA PI and Group 3 with abnormal UA PI/absent or reversed end diastolic flow. Neonatal outcomes were compared between each group.


RESULTS
Neonatal intensive care unit (NICU) admission, duration of hospital stay and perinatal mortality were higher in Group 3 as compared to the others. Group 2 had a lower birth weight and more fetuses with 5-min Apgar score <7 than Group 1; NICU admission and need for ventilators were also significantly higher than Group 1.


CONCLUSIONS
SGA fetuses with abnormal UA Doppler suffered more morbidity and mortality compared to those with normal UA Doppler. SGA fetuses with normal UA PI but abnormal MCA PI had worse outcomes compared to those with normal UA and MCA PI.
Nanthakomon
Tongta
T
Faculty of Medicine, Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand.
Uerpairojkit
Boonchai
B
D000293:Adolescent; D000328:Adult; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging* / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D013785:Thailand / Q000453:epidemiology; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*; D055815:Young Adult