Intrauterine growth retardation: prediction of perinatal distress by Doppler ultrasound.

To investigate the ability of umbilical artery Doppler findings to identify true cases at risk of fetal distress among 51 pregnancies clinically judged to be compromised by intrauterine growth retardation (IUGR) Doppler data were related to pregnancy outcome, which was classified into three groups-group 1, healthy babies with normal placental function (16 fetuses), group 2, fetuses with definite signs of placental failure (30), and group 3, non-classifiable pregnancies (5). Group 2 was subdivided into 2A, placental failure with manifest perinatal distress (19), and 2B, placental failure without perinatal distress (11). All 19 compromised and distressed fetuses (group 2A) had extremely pathological Doppler findings, even several weeks before fetal distress became apparent by cardiotocography. The Doppler findings in the 11 small-for-dates fetuses without perinatal distress (group 2B) were inconsistently normal or slightly pathological. All 16 normal infants (group 1) had normal antenatal Doppler data. The Doppler technique thus allows accurate and early recognition of those fetuses who will become distressed perinatally. It also helps to identify which fetuses clinically suspected of IUGR have an adequate placental circulation.