Performance of renal artery Doppler compared with umbilical artery Doppler in growth restricted fetuses

Alya Kamal Ibrahim Anwar, M.B.B.ch Resident at Mansoura Specialist HospitalFollow
Abdel-Aziz Abdel-Ghani Elrefae, Professor of Obstetrics and Gynecology Faculty of Medicine - Mansoura University
Khaled Samir Othman, Assistant Professor of Obstetrics and Gynecology Faculty of Medicine - Mansoura University
Alhussein Ahmed Mohamed, Assistant professor of Obstetrics& Gynecolgy Faculty of Medicine, Mansoura University

Subject Area

Obstetrics & Gynaecology

Article Type

Original Study

Abstract

Background:

Fetal growth restriction (FGR) is a major contributor to perinatal morbidity and mortality and is frequently associated with placental insufficiency. Doppler ultrasonography of blood flow is widely utilized in the assessment and follow up of pregnancy considered to be at high obstetric risk.

Objective:

This study aimed to compare the diagnostic performance of umbilical and fetal renal artery Doppler indices in prediction and monitoring of fetal growth restriction.

Methods:

This prospective observational study included pregnant women with fetuses whose EFW <10^th percentile for gestational age. A total of 90 women with suspected FGR were recruited. All participants underwent detailed ultrasound fetal biometry and Doppler assessment of the umbilical and fetal renal arteries at baseline and during follow-up. Doppler indices were compared between fetuses with and without neonatal growth restriction. Diagnostic performance of Doppler parameters was assessed using receiver operating characteristic (ROC) curve.

Results:

. At initial scan, fetuses with growth restriction had significantly higher umbilical artery resistance index (RI) and pulsatility index (PI) (P = 0.005 and P = 0.001 respectively). Fetal renal artery Doppler indices (RI, PI and S/D ratio) were also significantly elevated in growth-restricted group. During follow-up, umbilical artery Doppler indices demonstrated progressive deterioration among growth-restricted fetuses, with absent or reversed end-diastolic flow detected in 16.7% of cases. ROC analysis demonstrated that umbilical artery RI at follow-up had the best overall diagnostic accuracy for detection of FGR (AUC 0.890 ) , while Umbilical artery PI showed highest sensitivity 92.9%.. In contrast, fetal renal artery Doppler showed lower and non-significant AUC values, indicating limited diagnostic value especially at follow-up.

Conclusion:

Umbilical artery Doppler assessment; particularly pulsatility and resistance indices demonstrated high diagnostic accuracy for identifying and monitoring FGR . Fetal renal artery Doppler may provide complementary information during the early stages of evaluation. However, its diagnostic contribution appears limited in more advanced conditions.

Recommended Citation

Anwar, Alya Kamal Ibrahim; Elrefae, Abdel-Aziz Abdel-Ghani; Othman, Khaled Samir; and Mohamed, Alhussein Ahmed (2026) "Performance of renal artery Doppler compared with umbilical artery Doppler in growth restricted fetuses," Mansoura Medical Journal: Vol. 56 : Iss. 2 , Article 16.
Available at: https://doi.org/10.58775/2735-3990.1617