Doppler cerebro-umbilical ratio and fetal biophysical profile in the assessment of peripartal cardiotocography in growth-retarded fetuses.

OBJECTIVE: The aim of the study was to examine the value of the fetal biophysical profile (FBP) and the Doppler cerebro-umbilical ratio (C/U) in the assessment of peripartal cardiotocography (CTG) in growth-retarded fetuses.

METHODS: The prospective study included 58 pregnant women with singleton pregnancy from 28 to 42 weeks of gestation with clinically and ultrasonically verified late intrauterine growth retardation (IUGR). After assessment of the FBP, flow velocity waveforms from the umbilical and middle cerebral arteries were recorded and the C/U ratio was calculated. The C/U ratio and the FBP were assessed twice a week. The last peripartal CTG was used as an outcome parameter.

RESULTS: The FBP score was statistically significant when associated with peripartal CTG (p < 0.001). The mean value of the FBP was 7.77 +/- 0.28 for infants with a normal peripartal CTG, 6.13 +/- 0.41 for infants with a prepathological CTG and 4.40 +/- 0.60 for infants with a pathological peripartal CTG. There was also a statistically significant association between the C/U ratio > or =1 and normal CTG (p < 0.005), but there was no statistically significant difference between prepathological and pathological CTG in relation to C/U ratio values (p > 0.05). Normal and pathological peripartal CTG was correlated with the perinatal outcome, but prepathological CTG was not correlated with results of the perinatal outcome (p > 0.05).

CONCLUSIONS: Our results showed that both methods of fetal monitoring need to be used in perinatal monitoring of growth-retarded fetuses. The two methods can be used as important parameters in deciding to end pregnancies with IUGR when pathological values occur.