Syed Mehdi Raza Rizvi, Naila Yasmeen, Nasir Iqbal.
Small for gestational age fetus; role of colour Doppler ultrasound in the management.
Professional Med J Jan ;13(4):705-9.

Objective: To evaluate the role of Colour Doppler Ultrasound in the management of small for gestational age fetus. SGA or IUGR. Design: Descriptive study. Place & duration of study: Study performed in the Deptt. of Radiology & Deptt. of Gynae. & Obstetrics in Allied Hospital, Faisalabad from August 2005 to July 2006. Material & Methods: This study was carried out on 45 patients admitted through antenatal clinic having suspicion of carrying small for gestational age fetus. A brief clinical record including age, parity, nutritional status, intercurrent illness, per-vaginum bleeding, history of drug intake, smoking, past obstetrical history was recorded. Methods involved in screening SGA fetuses were measurement of Symphyseal Fundal Height chart & Ultrasound biometry, Biophysical profile (BPP), Cardiotocography (CTG), Middle cerebral and Umbilical Arteries Doppler studies were performed after admission in the management of SGA fetuses. All these information were recorded in a specially designed Performa. Results: Out of 45 SGA fetuses 15 (33.3%) were constitutionally small, 20(44.4%) had history of pre-eclampsia, 2(4.4%) had cardiac disease, 3(6.6%) had placental abnormalities, 5 (11.1%) had multiple gestations. Gestation of patients ranged between 30-36 weeks. Umbilical Artery Doppler was used as the primary surveillance tool. Small fetuses with normal Doppler and anomaly scan were managed on out-patient basis with fortnightly Doppler ultrasound. 15 patients (33.3%) with normal end-diastolic flow were delivered at 37 weeks. 20 patients (44.47%) with absent or reversed end-diastolic flow were delivered at 34-35 weeks. 10 patients (22.2%) at 30 weeks gestation with abnormal Doppler study were managed on CTG (Cardiotocography) & biophysical profile over a period ranging between 1-14 days. Perinatal mortality was 8,8% (4 cases) mostly due to extreme prematurity. Conclusion: Doppler ultrasound is a very helpful tool in the management of small for gestational age fetuses & it reduces perinatal morbidity & Mortality.

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