In a IUGR baby the Doppler finding which will most significantly predict the intra uterine deaths of the foetus: (DNB, Dec. 2008)
|A||Reversal of diastolic flow|
|B||Absent diastolic flow|
|C||Absent systolic flow|
|D||Presence of diastolic notch|
Reversal of diastolic flow
Doppler velocimetry of the umbilical artery is used to measure the peak systolic (S), peak diastolic (D), and mean values (M). In normal pregnancy, the SID ratio and the pulsatility index decreases as gestational age advances.
Following features in Doppler velocimetry are indicative of adverse fetal outcome:
a. Elevated uterine artery SID ratio (> 2.6).
b. Presence of diastolic notch in uterine artery.
c. Reduced or absent or reversed diastolic flow in umbilical artery.
However reversal is strongly suggestive of intra uterine death.