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To investigate the ability of umbilical artery Doppler findings in identifying true ca es at risk of fetal compromise among growthretarded fetuses, perinatal indicators of fetal compromise were assessed according to the results of pulsedwave Doppler un.bilical velocimetry for 73 patients who delivered an infant with a birth weight below tb ~ tenth percentile for gestational age. Perinatal outcomes were compared in the normal and abnormal systolic/ diastolic ratio groups according to the last Doppler study b, fore delivery. Twenty- nine(40%) had an abnormal A/ B(systolic /diastolic) ratio. Tae group with an elevated A / B ratio had a significantly higher incidence of pregnanc,,induced hypertension, late deceleration in labor, cesarean section for fetal distress, L,w Apgar score, neonatal resuscitation, admission into the neonatal intensive care unit aid neonatal complication associated with intrauterine growth retardation. Twentyfour l: ercent of the newborns required intermittent positive pressure ventilation and a pro-:)nged neonatal hospital stay was observed. Average birth weight and gestational age at .elivery were significantly lower and there were seven perinatal deaths in the group with an elevated A / B ratio and one in the group with a nomal A / B ratio. The sensitivity of the A / B ratio for an adverse perinatal outcome (operative delivery for retal distress, neonatal morbidity associated with IUGR, and / or perinatal death) was 80.9% and specificity 76.9%. The predictive value of an abnormal ratio was 58.6% and that of normal ratio was 90.9%. These data suggest that Doppler umbilical velocimety studies are valuable in identifying those growthretarded fetuses at increased risk for an adverse perinatal outcome.
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