Cerebral And Umbilical Artery Doppler Study in Normal and Growth-Restricted Pregnancies

Objective: To evaluate the role of umbilical artery (UA) and middle cerebral artery (MCA) Doppler indices, their ratios, and the umbilical artery systolic/diastolic (S/D) ratio in predicting intrauterine growth restriction (IUGR) and adverse perinatal outcomes, and to compare their diagnostic accuracy.Methods: This prospective observational study was conducted at Jawaharlal Nehru Hospital and Research Centre, Bhilai. Pregnant women between 30 and 41 weeks of gestation were enrolled and categorized into a study group with growth-restricted fetuses and a control group with normal pregnancies. Doppler assessment of UA and MCA was performed, and pulsatility indices (PI), S/D ratio, and cerebro-umbilical ratio (CUR) were calculated. Perinatal outcomes were recorded and correlated with Doppler findings.Results: The mean gestational age at enrollment was 35.8 weeks in the study group and 36.7 weeks in the control group. Umbilical artery PI and S/D ratios were significantly higher in the study group (p < 0.001), while MCA PI and CUR were significantly lower (p ≤ 0.001). Abnormal CUR showed the highest sensitivity (83.6%), specificity (98.6%), and diagnostic accuracy (94.5%) for predicting adverse perinatal outcomes, outperforming individual vessel Doppler indices.Conclusion: The cerebro-umbilical ratio is the most reliable Doppler parameter for predicting IUGR and adverse perinatal outcomes. Routine use of Doppler velocimetry, particularly CUR, in high-risk pregnancies can facilitate timely intervention and improve perinatal outcomes.