Subclassification of small-for-gestational-age fetus using fetal Doppler velocimetry

Our purpose was to determine whether small-for-gestational-age (SGA) fetus can be divided to subclassified groups using fetal Doppler velocimetry. Fif ty-four pregnant women with SGA infant delivered after 37 weeks of gestatio n were studied. After 24 weeks of gestation, fetal middle cerebral artery p uslatility index (MCAPI) and umbilical artery pulsatility index (UAPI) were measured at 2-to 3-week intervals using Doppler ultrasound. Perinatal outc omes [operative delivery due to feta I distress, abnormal fetal heart rate (FHR) pattern, meconium staining, low Apgar score (<7), neonatal acidosis ( umbilical artery blood pH <7.15), neonatal intensive care unit (NICU) admis sion due to neonatal asphyxia, and decreased amniotic fluid] were compared in subclassified SGA groups using fetal Doppler velocimetry. The number of SGA fetuses with normal MCAPI and UAPI (normal SGA group) was 39, and those with significantly low MCAPI but normal UAPI (eventful SGA group) 15, resp ectively. Birth age and birth weights in the eventful SGA group were signif icantly earlier and lower than those in the normal SGA group, respectively (p < 0.05, and p < 0.005). There were significant increases in operative de liveries, abnormal FHR patterns and decreased amniotic fluid in eventful SG A group, when com pa red with events related to normal SGA group. However, there were no significant differences in meconium staining of amniotic flui d, low Apgar score, neonatal acidosis, and NICU admission between the two g roups. These results suggest that SGA fetus with abnormally low MCAPI but n ormal UAPI has more poor perinatal outcomes, compared with that with normal MCAPI and UAPI. Copyright (C) 2000 S. Karger AG, Basel.