Sadaf Naveed, Kalsoom Nawab, Humaira Anjum, Inayat Shah Roghani, Majid Khan



Intrauterine growth restriction (IUGR) results from placental insufficiency. Preeclampsia is one of the major risk factors responsible for placental insufficiency. Early identification of the IUGR helps in reducing perinatal morbidity and mortality. Doppler flow velocity waveform analysis in the uterine arteries has proved to be a useful method for evaluation of uteroplacental insufficiencyand hence prediction of IUGR.


To determine the diagnostic accuracy of uterine artery Resistance Index (RI) in the prediction of IUGR in preeclampsia taking neonatal weight at birth as gold standard.


A Cross sectional study was conducted at Radiology Department, Khyber Teaching Hospital, Peshawar over a period of 6 months (17th January 2019 to 16th June 2019). 281 patients diagnosed with preeclampsia underwent Doppler ultrasound to calculate Uterine Artery RI. Sensitivity, Specificity, Positive Predictive Value, Negative Predictive value and Diagnostic Accuracy of the Uterine Artery RI in the prediction of IUGR was calculated.


281 pre-eclamptic patients underwent doppler ultrasound for determination of Uterine Artery RI in order to predict IUGR. Sensitivity, Specificity, Positive Predictive value, Negative predictive value of the Uterine Artery RI in the prediction of IUGR was found to be 78.99%, 89.51%, 87.90%, 81.53% respectively. The diagnostic accuracy of Uterine Artery RI taking birth weight as gold standard was found to be 84.34%.


Uterine Artery RI determination can help in detection of IUGR in pre-eclamptic patients and hence timely intervention can be made possible.


Doppler ultrasound, intrauterine growth restriction, placental insufficiency, uterine artery resistance

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Ibrahim MI, Akram MH, Nafees M. Sensitivity and specificity of pulsatility index umbilical artery and middle cerebral artery in detecting intrauterine growth retardation. Pak Armed Forces Med J. 2014;64(1):161.

Rajesh M, Agamya S. Role of colour doppler indices in the diagnosis of intrauterine growth retardation in high-risk pregnancies. J Obstet Gynecol India. 2013;63(1):37.

Anita B, Mala S, Indrani G. Divergent systolic diastolic ratio of the uterine arteries and its significance. J Obstet Gynecol India. 2010;60(4):320.

Chander L, Sonal G. Colour doppler in IUGR- Where are we and where do we go? J Obstet Gynecol India. 2010;60(4):301.

Miller J, Turan S, Baschat AA. Fetal growth restriction. Semin Perinatol. 2008;32(4):274–80.

Douglas KA, Redman CW. Eclapmsia in United Kingdom. BMJ 1994; 309: 1395 – 400.

Thaler I, Manor D, Itskovitz J, Rottem S, Levit N, Timor-Tritsch I, et al. Changes in uterine blood flow during human pregnancy. Am J Obstet Gynecol 1990;162(1):121-5.

Kofinas AD, Espeland MA, Penry M, Swain M, Hatjis CG. Uteroplacental Doppler flow velocity waveform indices in normal pregnancy: A statistical exercise and the development of appropriate reference values. Am J Perinatol 1992;9(2):94-101.

Palmer SK, Zamudio S, Coffin C, Parker S, Stamm E, Moore LG.. Quantitative estimation of human uterine artery blood flow and pelvic blood flow redistribution in pregnancy. Obstet Gynecol. 1992;80(6):1000-6.

den Ouden M, Cohen-Overbeek TE, Wladimiroff JW. Uterine and fetal umbilical artery flow velocity waveforms in normal first trimester pregnancies. Br J Obstet Gynaecol.1990; 97(8):716-9.

Magee LA, Ornstein MP, von Dadelszen P. Management of hypertension in pregnancy. BMJ. 1999;318:1332.

Niknafs, Parvin. Identification of Intrauterine growth restricted babies: development of an IUGR index, Doctor of Philosphy thesis, Department of Nursing, University of Wollongong, 2000. http://ro.uow.edu.au/theses/1614

Bower S, Schuchter K, Campbell S. Doppler ultrasound screening as part of routine antenatal scanning: Prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol. 1993;100(11):989-94.

Singh S, Verma U, Shrivastava K, Khanduri S, Goel N, Zahra F et al. Role of color doppler in the diagnosis of intra uterine growth restriction (IUGR). Int J Reprod Contracept Obstet Gynecol. 201;2(4):566.

Florjanski J, Zimmer M, Tomiałowicz M, Pomorski M. Uterine artery Doppler in prediction of fetal intrauterine growth restriction and hypertension during pregnancy. Ginekologia i Poloznictwo.2011;19:9-14.

Barati M, Shahbazian N, Ahmadi L, Masihi S. Diagnostic evaluation of uterine artery Doppler sonography for the prediction of adverse pregnancy outcomes. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences. 2014;19(6):515-519.

Cnossen JS, Morris RK, ter Riet G, Mol BWJ, van der Post JAM, Coomarasamy A, et al. Use of uterine artery Doppler ultrasonography to predict pre-eclampsia and intrauterine growth restriction: a systematic review and bivariable meta-analysis. CMAJ : Canadian Medical Association Journal. 2008;178(6):701-11.


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