Value of mid-trimester Doppler ultrasound as predictors of SGA

초록

Objectives To estimate the value of sonographic Doppler screening at 2nd trimester of pregnancy for small for gestational age. Methods This was a retrospective study of women with singleton pregnancy, who had regular antenatal examination including ultrasound assessment. Doppler ultrasound of umbilical artery, uterine artery, umbilical vein and middle cerebral artery was performed between 16 and 26 weeks of gestation. The main outcome measure was SGA (birthweight <10th centile). Results Three hundred and thirty-two women enrolled had 22(6.6%) SGA babies. The rate of smoking, hypertensive disorder of pregnancy, gestational diabetes and pregestational diabetes and hypertension were not different. Neonatal morbidities were similar between AGA and SGA babies. Among various Doppler parameters, middle cerebral artery peak systolic velocity (MCA PSV) (p < 0.001) and cerebroplacental ratio (CPR) (p = 0.009) was significantly higher in SGA group. After adjustment for maternal age, hypertensive disorder in pregnancy and pregestational HTN, MCA PSV and CPR at 2nd trimester remained independent predictors of SGA by 1.2(95% CI 1.090-1.448) and 4.3(95% CI 1.237-14.781). Conclusions MCA PSV and CPR at 2nd trimester performed best in the prediction of SGA. Further studies on these markers are necessary to explain why these markers were changed. Especially elevated CPR in SGA should be evaluated prospectively.