Clinico sonographic correlation of intrauterine growth restriction

Abstract

Aim and Objectives: To study was a clinic sonography correlation of the following factors associated with Intrauterine Growth Restriction.Material and Methods: This was a prospective study of 150 cases of intrauterine foetal growth restriction studied in a tertiary care institute over a period of 1 year (April 2015 to March 2016). Patients suspected to have IUGR were admitted in antenatal ward for varying period of time ranging from minimum 1 week to more than 3 weeks. Maternal monitoring and foetal monitoring was done. In maternal monitoring - pulse, BP, urine albumin were recorded, Serial increase in Fundal height, abdominal girth, maternal weight was recorded. In foetal monitoring - Strict Daily Foetal Kick Count (DFKC) was maintained. Results: In our study, 52 cases (34.67%) had mild IUGR with birth weight between 1.5- 2.5kg, 93 (62%) had moderate IUGR with birth weight between 1- 1.5 kg, and 5 cases (3.33%) cases had severe IUGR with birth weight less than 1 kg. Doppler studies (99.33% sensitive) and ultrasound (100% sensitive) studies are highly sensitive in detecting intrauterine fetal growth restriction as compared to clinical examination (81.33%). In our study, 70 cases (46.66%) had vaginal delivery and 80 (53.34%) cases had to undergo LSCS-81.25% were Emergency and 18.75% were Elective cases. The most common indication for Emergency LSCS was oligohydramnios and abnormal Doppler with Fetal Distress. Incidence of neonatal mortality in our study was 10.67%, 15 Neonatal deaths and 1 Fresh stillbirth.Conclusion: Early detection of maternal high risk factors by detailed history, meticulous clinical examination and appropriate use of imaging modalities like ultrasound and Colour Doppler and appropriate antenatal care is essential in reducing burden of Low Birth Weight babies in India.