PREDICTIVE VALUE OF A SINGLE CTG, ULTRASOUND AND DOPPLER EXAMINATION TO DIAGNOSE ACUTE AND CHRONIC PLACENTAL INSUFFICIENCY IN MULTIPLE PREGNANCIES

A non-stress test, an ultrasound biometry (biparietal and abdominal di ameter) and a Doppler sonography blood flow measurement (fetal descend ing aorta, umbilical artery and fetal middle cerebral artery) were per formed in the third trimester of 130 multiple pregnancies. These three methods were compared in terms of their prognostic value for fetal gr owth retardation (81 from 263 children; defined as weight at birth < 1 0 percentile) and a pathological ''fetal outcome'' (76 from 263 childr en, defined as 5-min-Apgar < 8, umbilical artery-pH < 7.20 and transfe r to neonatal intensive care unit). Fetal growth retardation could bes t be predicted by means of the Doppler results for all three blood ves sels (''total Doppler result'') (sensitivity of 75.9%). Doppler result s for all three blood vessels showed the best result in predicting a p athological ''fetal outcome''; the sensitivity was 60.3%. The biometri c examinations with ultrasound and the non-stress test produced worse results compared to Doppler sonography Doppler velocimetry of only one blood vessel showed worse results compared to Doppler velocimetry of moere than one blood vessel. Doppler sonography should be performed as a routine test for all multiple pregnancies. More intensive pregnancy surveillance is urgently recommended with pathological findings.