Role of TCD/AC Ratio in Diagnosis of Asymmetrical IUGR
Journal Title: Gujarat Medical Journal - Year 2017, Vol 72, Issue 2
Abstract
Introduction : "Intrauterine growth restriction"(IUGR), refers to poor growth of a foetus, while in the mother's womb, during pregnancy. IUGR affects 3-10% of pregnancies. Perinatal mortality rates are 4-8 times higher for infants with IUGR, and morbidity is present in 50% of surviving infants. There are 2 major categories of IUGR: Symmetrical and Asymmetrical. Asymmetrical IUGR, result of Acute insult, over a short period, is more common (70%). This type of IUGR is most commonly caused by extrinsic factors that affect the foetus at later gestational ages. TCD/AC Ratio: The cerebellum is located in the posterior cranial fossa, well protected within the strong bones, thus withstanding the extrinsic pressure better.Abdominal circumference reflects the size of the liver (which correlates with the degree of foetal malnutrition) as well as the volume of subcutaneous plane. Therefore, AC predicts growth restriction more accurately, than either BPD or FL. Hence, a morphometric ratio of TCD/AC can be used to predict asymmetrical IUGR. Materials & Method : The study will consist of pregnant women within inclusion & exclusion criteria. 50 patients who has high risk for IUGR and 50 patients with normal pregnancy will recruited for the clinical study. The study done, is entirely based on sonography findings, of both group patients. The parameters taken in consideration, for assessment, as well as, comparison are H.C. ,A.C., T.C.D. , T.C.D./A.C. & H.C./A.C. ratios, of patients of both groups. Result & Discussion : In study group, FOR TCD/AC Ratio Sensitivity was 75%, Specificity was 94.4%, PPV was 96% & NPV was 68%. While FOR HC/AC Ratio Sensitivity was 53.12%, Specificity was 77.8%, PPV was 80.95% & NPV was 48.28%.From all these results, one fact emerges, that for prediction of I.U.G.R., in all cases, with or without any risk factor for growth retardation, TCD/AC ratio provides more reliable index, for susceptible cases, than HC/AC ratio
Authors and Affiliations
Apexa Patel, Deepak Desai
Keywords
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