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Ultrasound predictors of neonatal outcome in intrauterine growth restriction
S D Craigo1, M L Beach, K B Harvey-Wilkes
1Division of Maternal Fetal Medicine, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts 01211, USA.
Insights
Ultrasound parameters like absent umbilical artery blood flow and low amniotic fluid can predict adverse neonatal outcomes in fetuses with intrauterine growth restriction (IUGR), including death.
Area of Science:
- Perinatology
- Fetal Medicine
- Neonatal Ultrasound Diagnostics
Background:
- Intrauterine growth restriction (IUGR) poses significant risks to neonatal well-being.
- Accurate prediction of adverse outcomes in IUGR fetuses is crucial for timely intervention.
- Standard ultrasound parameters require evaluation for their predictive value in IUGR.
Purpose of the Study:
- To evaluate the efficacy of common ultrasound parameters in predicting neonatal outcomes for fetuses diagnosed with IUGR.
- To identify specific ultrasound markers that correlate with severe adverse neonatal courses and mortality.
Main Methods:
- A retrospective analysis of 127 fetuses diagnosed with IUGR via ultrasound.
- Assessment of estimated fetal weight percentile, amniotic fluid volume, umbilical artery Doppler velocimetry, and head circumference/abdominal circumference ratio.
- Comparison of ultrasound findings with documented neonatal outcomes, including adverse events and mortality.
Main Results:
- The severity of growth restriction directly correlated with adverse neonatal outcomes and mortality.
- Absent or reversed end-diastolic flow in umbilical artery Doppler velocimetry predicted neonatal death, bronchopulmonary dysplasia (BPD), and necrotizing enterocolitis (NEC).
- Oligohydramnios was also a significant predictor of adverse outcomes and neonatal death.
Conclusions:
- Ultrasound findings, including low estimated weight percentile, absent/reversed end-diastolic umbilical blood flow, and oligohydramnios, are independent predictors of adverse neonatal outcomes in growth-restricted fetuses.
- These ultrasound parameters provide valuable prognostic information for managing fetuses with IUGR.
Abstract:
Our purpose was to assess the value of commonly performed ultrasound parameters in predicting neonatal outcome of fetuses with intrauterine growth restriction (IUGR). One hundred twenty-seven patients were identified on ultrasound examination to have IUGR. Estimated weight percentile, amniotic fluid volume, umbilical artery Doppler velocimetry, and head circumference/abdominal circumference ratio were compared with neonatal outcome. Thirty infants had severely adverse courses. The degree of growth restriction was strongly associated with adverse outcome and neonatal death. Umbilical artery Doppler waveforms with absent or reverse end-diastolic flow were predicted of neonatal death, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and adverse outcome in general. Oligohydramnios was predictive of adverse outcome and neonatal death. Logistic regression also showed that absent or reverse end-diastolic flow and oligohydramnios were independent predictors of adverse outcome. Ultrasound findings of low estimated weight percentile, absent or reverse end-diastolic umbilical blood flow, and oligohydramnios are independent predictors of adverse neonatal outcome of growth restricted fetuses.