Journal of Ultrasound in Medicine, Vol 19, Issue 10 661-665, Copyright © 2000 by American Institute of Ultrasound in Medicine
Intrauterine growth restriction and Doppler ultrasonography
W. J. Ott
Department of Obstetrics and Gynecology, St. John's Mercy Medical Center, St. Louis, Missouri 63141, USA.
To clarify the difference between the fetus that is small for gestational
age and the fetus with true intrauterine growth restriction, we undertook a
retrospective study of singleton fetuses who had fetal weight estimation
and umbilical artery Doppler velocity studies within 2 weeks of their
delivery. Fetuses were divided into four categories on the basis of
sonographic results from their last examination. Statistical comparisons of
neonatal outcome were made for the four groups, which totaled 578 fetuses.
Increased cesarean section for fetal distress, stays in the neonatal
intensive care unit, and increased neonatal morbidity were seen in both
small for gestational age and average for gestational age neonates with
abnormal Doppler blood flow. The small for gestational age fetuses with
normal Doppler studies showed no increased morbidity when compared with
their average for gestational age cohorts. Umbilical artery Doppler blood
flow studies were a better predictor of neonatal outcome than estimated
fetal weight. Small for gestational age fetuses with normal Doppler studies
most likely represent constitutionally small, not pathologically growth
restricted, fetuses.
