COMPARISON OF DIAGNOSTIC VALUES OF DOPPLER INDICES FOR PREDICTING THE INTRAUTERINE GROWTH RETARDATION (IUGR) IN PREECLAMPTIC WOMEN

Abstract

Background: Intrauterine growth restriction (IUGR) is a significant complication of preeclampsia, contributing to increased perinatal morbidity and mortality. Timely detection of IUGR through non-invasive modalities such as Doppler ultrasonography can enable early interventions and improve neonatal outcomes. Among various Doppler indices, the cerebroplacental ratio (CPR), umbilical artery pulsatility index (UA-PI), and middle cerebral artery pulsatility index (MCA-PI) have been commonly employed, though their diagnostic accuracy in preeclamptic populations remains under investigation.

Objective: To compare the diagnostic performance of UA-PI, MCA-PI, and CPR in predicting IUGR among preeclamptic women.

Methods: A cross-sectional validation study was conducted on 202 preeclamptic women aged 16 to 40 years, with singleton pregnancies between 24 and 28 weeks of gestation, at the Radiology Unit of Northwest General Hospital, Peshawar. Doppler ultrasonography was performed to assess UA-PI, MCA-PI, and CPR using a 3–5 MHz transducer. All Doppler measurements were recorded during fetal inactivity. Neonatal birth weight was documented at delivery, and IUGR diagnosis was confirmed based on standard birth weight criteria. Diagnostic performance was evaluated by calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy.

Results: UA-PI demonstrated a sensitivity of 63.81%, specificity of 68.04%, PPV of 68.37%, NPV of 63.46%, and diagnostic accuracy of 65.84%. MCA-PI showed sensitivity of 55.24%, specificity of 71.13%, PPV of 67.44%, NPV of 59.48%, and diagnostic accuracy of 62.87%. CPR had the highest sensitivity (79.05%), specificity (71.13%), PPV (74.77%), NPV (75.82%), and diagnostic accuracy (75.25%).

Conclusion: CPR emerged as the most accurate and reliable Doppler index for predicting IUGR in preeclamptic women, outperforming both UA-PI and MCA-PI.