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[Intrauterine weight index in fetal growth retardation]
J A Robert1, R Gómez, G Gormaz
1Departamento de Obstetricia y Ginecología, Pontificia Universidad Católica de Chile.
Insights
Ultrasonographic estimation of the intra uterine ponderal index (IPI) in fetuses with intrauterine growth retardation (IUGR) can identify high-risk pregnancies. Lower IPI values (< p10) correlate with increased rates of cesarean section, fetal distress, and neonatal morbidity.
Area of Science:
- Obstetrics and Gynecology
- Fetal Medicine
- Diagnostic Imaging
Background:
- Intrauterine growth retardation (IUGR) poses significant risks to newborns.
- Accurate assessment of fetal well-being in IUGR cases is crucial for perinatal management.
- Existing methods for evaluating fetal growth may require enhancement for improved risk stratification.
Purpose of the Study:
- To evaluate the utility of the intra uterine ponderal index (IPI), estimated via ultrasound (US), in diagnosing fetal condition in IUGR cases.
- To determine if IPI can differentiate fetuses with higher perinatal risk among those with IUGR.
- To assess the correlation of IPI with neonatal outcomes.
Main Methods:
- Ultrasound examinations were performed on 79 patients diagnosed with IUGR.
- The intra uterine ponderal index (IPI) was calculated using a specific sonographic formula.
- Correlation between IPI, estimated fetal parameters, and neonatal outcomes (weight, length, ponderal index) was analyzed.
Main Results:
- The IPI showed a significant correlation with neonatal weight, length, and ponderal index (r=0.51, p < 0.001).
- Fetuses with an IPI below the tenth percentile (p10) exhibited significantly higher rates of cesarean section, intrapartum fetal distress, low Apgar scores, and neonatal morbidity.
- No significant difference in antepartum meconium presence was observed between groups.
Conclusions:
- Ultrasonographic estimation of IPI is a valuable tool for assessing fetal condition in IUGR.
- IPI can help identify fetuses with estimated weight below the tenth percentile who are at increased perinatal risk.
- Incorporating IPI into routine ultrasound examinations can aid in better diagnosis and management of IUGR pregnancies.
Abstract:
The intra uterine ponderal index (IPI) estimated by ultrasound examination (US) in 79 patients with intrauterine growth retardation (IUGR) is presented. The IPI was calculated using the following formula: [formula: see text] 13.2 (DFO) + 22 (DAT) + 8.9 (DAP) - 48.4 (LF) - 7469.1, and ETF = 0.55 (LF) + 8.66. Correlation indexes (r) of EPF, ETF and IPI with neonatal weight, length and ponderal index were 0.92, 0.87 and 0.51 (p < 0.001). The IPI revealed a gradual increase with respect to gestational age ranging from 1.63 to 3.08. The p 10 of the IPI was 1.96 for pregnancies of 30 to 34 weeks and 2.35 for pregnancies of 35 to 39 weeks. Those cases of IUGR with IPI < p 10 (n = 7) had a higher incidence of cesarean section (86% vs 30%, p < 0.01), intrapartum fetal distress (71% vs 11%, p < 0.01), Apgar score of < 7 at 5' (29% vs 1.4%, p < 0.05), PBF < 5 points (43% vs 4.7%, p < 0.01), and moderate or severe neonatal morbidity (57% vs 21%, p < 0.05) than those with IPI > or = p 10 (n = 72). No difference were found with respect to the presence of antepartum meconium (29% vs 6%, p = 0.09). In conclusion, ultrasonographic estimation of the IPI is another element of the examination that can help in the diagnosis of fetal condition in cases of IUGR, permitting to distinguish those fetuses that, having and estimated weight below the tenth percentile in a growth curve, are in higher perinatal risk.