Uterine Artery Doppler as Predictive Measure for Fetal Growth Restriction in Chronic Hypertensive Patients

Background: Fetal growth restriction (FGR) is when the fetal weight is less than tenth centile for the given gestational age. Chronic hypertension is one of the risk factors of FGR. Growth restricted fetuses are at risk of intrauterine death and many comorbidities later in life. Detection of those fetuses at risk of developing FGR can help in timely intervention and better outcome.Objective: To evaluate uterine artery Doppler for prediction of FGR in patients with chronic hypertension.Methods: One hundred and sixty four women having chronic hypertension at 24 weeks of gestation were included in the study. Women with multiple pregnancy and comorbidities other than hypertension were excluded. Doppler USG of uterine arteries was done at 24 weeks of gestation by radiologist and absence or presence of diastolic uterine artery notch was observed. Patients were divided into 2 groups A and B depending upon the presence or absence of notch respectively. These women were followed till they delivered and by taking birth weight as an outcome measure, frequency of fetal growth restriction (FGR) was found in both groups by the researchers themselves.Results: The mean age of women in group A was 26.76± 3.89 and in group B was 26.21 ± 3.57 years. Major portion of women was multipara 58% (96 women). Forty (24.39%) patients developed fetal growth restriction while 124 patients (75.61%) fetuses were of normal weight. Among the patients who had growth retarded foetuses 35.37% patients were in group A and 13.41% were in group B with p-value of 0.001.Conclusion: Uterine artery doppler diastolic notch at 24 weeks of gestation has significant association with development of FGR in patients with chronic hypertension.