What is the role of arterial and venous Doppler deteriorations in predicting neonatal outcomes in growth-restricted fetuses?

INTRODUCTION: The study aims to evaluate the performing fetal arterial and venous Doppler to detect the optimal time for delivery in growth-restricted fetuses and its effect on perinatal outcomes.
METHODS: Forty-five pregnant women with intrauterine growth restriction were included in the study. Fetal umbilical artery (UA), middle cerebral artery (MCA), and ductus venosus (DV) Doppler measurements were performed. Fetuses were investigated in three groups: normal Doppler findings, only arterial Doppler abnormality, and venous Doppler abnormality. Cord arterial gas was analyzed at the time of delivery. Neonatal information and complications (Apgar score, neonatal intensive care unit (NICU) necessity, mechanical ventilation, respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH)) were noted.
RESULTS: A total of 45 growth-restricted fetuses consist of 15 (%33,3) normal Doppler findings, 22 (%48,8) abnormal arterial Doppler findings, and 8 (%17,7) abnormal venous Doppler findings. There was a statistically significant difference between the abnormal venous Doppler group and the normal Doppler group when compared for gestational age at delivery, birth weight, emergent cesarean section due to fetal distress, acidosis, neonatal complications (NICU necessity, mechanic ventilation time, RDS, NEC, ÝVH) (p<0,05). As well, there was a strong correlation between gestational age and duration of both NICU stay and mechanical ventilation.
DISCUSSION AND CONCLUSION: Several parameters should be performed for the surveillance and then the optimal delivery timing of growth-restricted fetuses. Our study supports that venous Doppler investigation is more predictive for fetal well-being and perinatal outcomes than the mild deterioration of the umbilical artery and middle cerebral artery.