Journal of Ultrasound in Medicine, Vol 7, Issue 12 655-659, Copyright © 1988 by American Institute of Ultrasound in Medicine
Doppler criteria for intrauterine growth retardation: predictive values
C. B. Benson and P. M. Doubilet
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.
Published data concerning proposed antenatal Doppler criteria for
intrauterine growth retardation (IUGR) were critically analyzed using the
same technique that has been previously applied to conventional
(non-Doppler) sonographic criteria for IUGR. Fifteen studies of Doppler
criteria, each conducted in such a way that sensitivity and specificity
could be determined, were identified through a literature review. These
studies encompassed a variety of arterial waveform and volume blood flow
criteria. Bayes' theorem was then used to determine the positive predictive
value of each criterion if used as a screening test for IUGR. Criteria
involving vessels that have been studied by at least two groups, including
those involving umbilical artery waveform, uterine arcuate artery waveform,
and umbilical vein volume blood flow, had positive predictive values that
fell in a low range (17-57%) similar to that previously found for
conventional criteria. Two criteria, using fetal internal carotid artery
and thoracic aortic waveforms, had higher positive predictive values (66
and 100%, respectively) in initial studies, but the data have yet to be
replicated by other groups. It is concluded that no Doppler criterion has
yet been established as a clinically useful method to screen for IUGR
antenatally.
