Predictive value of MCA / AO doppler parameter for prediction of perinatal results in İUGR pregnant women

ABSTRACT In this study, we think that fetal pulmonary artery Doppler indices, which In this study, it was aimed to determine the predictive values of the middle cerebral artery (MCA) and descending aorta (AO) doppler parameter in predicting perinatal outcomes in pregnant women with IUGR of 34 weeks and above. In this study, which was conducted as a prospective cohort study, it was conducted between November 2018 and March 2019 at Ege University Faculty of Medicine, Department of Women and Obstetrics. In this study, a total of 61 infants, 20 patients with IUGR and 41 patients with control group who were born after 34 weeks of gestation without congenital anomaly and pregnancy complications, were included in the study. An ultrasound examination was performed using a Samsung Medison H60 ultrasound device equipped with a 3.5 MHz convex array transducer by considering the fetal movements by a single experienced specialist. After fetal ultrasound examination; fetal MCA / AO Doppler current waveforms were obtained. All doppler measurements were carried out in the absence of fetal movement and in the period of apnea, with the insonation angle being as close to 0 as possible and including the sample volume vessel. The insonation angle of the image was kept at <20. MCA, UmB artery, Descending aortic artery (just below the renal bifurcation), pulsatility index (PI), resistance index (RI) ratio, were measured in two measurements. The values of these two measurements were recorded as calculated Doppler index. In addition, newborn features such as first and fifth minute Apgar scores, neonatal intensive care unit (NICU) and neonatal weight, sex were recorded. SPSS 23.0 (SPSS Inc., Chicago, Illinois, USA) program was used in the statistical analysis. In all statistical evaluations, 95% confidence interval, p≤0.05 was considered significant. The mean age of the patients in the IUGR group was 28.15 ± 5.19 years and the mean age of the control group was 28.91 ± 5.31 years. 55% of the babies in the IUGG group were girls and 45% were boys. While 56,10% of the babies in the control group were girls, 43,9% of them were male. The mean IUGR group was 37,25 ± 1,25hft and the control group had a mean of 38,11 ± 1,26 hft birth week. In addition, the relationship between gravida and parity was significant in both groups. In the IUGG group, the mean MCA Rİ / AO Rİ was 0.93 ± 0.17, the mean MCA Pİ / AO Pİ was 0.89 ± 0.34, the mean MCA Rİ / Umb Rİ was 1.25 ± 0.19 and MCA Pİ / The mean value of UmB PI was 1.61 ± 0.49. In MCA / AO, the number of patients with a RI ratio of less than 1 is 10, while the number of patients with a MCA / Umb Rİ ratio of less than 1 is 3. The mean MCA RI / AO RI value of the patients in the control group was 1.06 ± 0.13, the mean of MCA PI / AO was 1.10 ± 0.36, the mean of MCA RI / Umb RI was 1.32 ± 0.22 and MCA PI The mean PU value was found to be 1.84 ± 0.54. The MCI, AO and Umbilical artery RI values were below 1, and the sensitivity was 85%, Spesificity 98.3%, Positive Predictive Value 84%, Negative Predictive Value 80% and Accuracy 98.3%. It was determined that 25% of the babies in the IUGR group and 7,32% of the babies in the control group needed neonatal intensive care. Significant correlations were found between MCA PI / AO PI value and cord blood pH value and neonatal intensive care need. age and gravida, parity, MCA RI / Umb RI and MCA PI / UmB PM were found to be significantly correlated with gravida age, between parity, age with parity, gravida, weight, between MCA RI / AO RI and MCA PI / AO PI. Statistically significant relationships between weight and BMI were determined. The results of this study can be used safely to predict the perinatal outcomes of middle cerebral artery (MCA) and descending aorta (AO) doppler parameter in pregnant women with IUGG at 34 weeks of age. Keywords: MCA, AO, Doppler Ultrasound, IUGR, Perinatal Outcome, Predictive Value