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139: Role of middle cerebral artery (MCA) doppler for prediction of adverse neonatal outcome in fetal growth restriction (FGR)

      Objective

      Several Doppler indices, including peak systolic velocity (PSV) and pulsatility index (PI) at MCA, and umbilical artery (UA) PI have been proposed as predictors of adverse outcome in FGR. We have evaluated their independent predictive ability for neonatal complications.

      Study Design

      In a cohort of singleton pregnancies diagnosed as FGR based on abdominal circumference <10th centile, demographic and sonographic factors were related to admission to NICU for reasons other than low birth weight alone using univariate and logistic regression analysis.

      Results

      The study included a total of 55 cases; 14 were excluded for birth weight >9th centile. Average birth weight centile was 3.6 (range 0.1-9.0) and gestational age (GA) at delivery was 36.2 +/− 3.2 weeks. The interval between last MCA and delivery was 9.7 +/− 11.4 days. Multivariate analysis showed that among variables available to the obstetrician, including severity of FGR, only MCA-PSV was independently associated with adverse neonatal outcome (P=0.04).

      Conclusion

      Doppler assessment of MCA-PSV is the best prenatal predictor of admission to the NICU for reasons other than low birth weight alone.