Changes in doppler parameters in severe fetal growth restriction and its association with perinatal outcomes in an Indian tertiary care centre

: Fetal growth restriction (FGR) poses significant challenges in modern obstetrics, with its prevalence notably high in India. Identifying the progression patterns of Doppler parameters in severe FGR pregnancies caused by placental insufficiency remains underexplored, particularly in the Indian context. : This prospective observational study, conducted at an Indian tertiary care hospital between 2020 and 2021, enrolled 40 pregnant women with severe FGR. Serial Doppler assessments were performed on maternal and fetal vessels, including umbilical artery (UA), middle cerebral artery (MCA), ductus venosus (DV), umbilical vein, and uterine artery. Patients were monitored until delivery, with perinatal outcomes assessed. : In our study, abnormalities in umbilical artery pulsatility index (UA PI) progressed gradually, with early-onset cases showing more rapid deterioration. Uterine artery pulsatility index (UtA PI) abnormalities persisted, especially in subjects with hypertensive disorders. Middle cerebral artery (MCA) abnormalities were universal at delivery, indicating brain sparing. Three patterns of Doppler deterioration based on placental insufficiency severity were observed: mild, progressive, and severe early-onset. Statistically significant differences (ANOVA P < 0.0001) were found in the median intervals from abnormal Doppler parameters to delivery. : Understanding the longitudinal progression of Doppler abnormalities in severe FGR pregnancies is crucial for optimizing perinatal outcomes. Early detection and monitoring of Doppler parameters can guide timely interventions and improve management strategies for FGR. Further research is warranted to validate these findings and explore their clinical implications fully.