“ANTENATAL ASSESSMENT OF INTRAUTERINE GROWTH RESTRICTION USING CLINICAL AND ULTRASONOGRAPHIC EVALUATION IN COMPARISON WITH POSTNATAL DIAGNOSIS”

Abstract

Introduction: Identifying the factor (s) leading to IUGR and its management thus play an important role in reducing perinatal morbidity and mortality. Aim of the study is to assess intrauterine growth restriction in the antenatal period by clinical and ultrasound means. Materials and methods:A hospital-based prospective observational study was conducted on 249 pregnant women attending the antenatal OPD in Sri manakula vinayagar Medical college and Hospital , Pondicherry from July 2022 to June 2023. Women in the first trimester with singleton pregnancies who gave informed consent were included, while those with polyhydramnios, fetal anomalies, diabetes, intrauterine death, uterine anomalies, and multiple pregnancies were excluded. Participants were followed at 24–28 weeks, 32–34 weeks, and term with counselling, history, clinical examination, and ultrasound with Doppler. Birth weight was taken as the reference standard. The validity of clinical methods, ultrasound, and Doppler was compared. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy were calculated using Microsoft Excel 2010 and SPSS version 20. Results: Most participants were aged 20–25 years (54.2%), with the majority residing in rural areas (72%). Symphysio fundal height demonstrated higher accuracy with sensitivity 88.6% and specificity 95.4%. It proved more reliable than fundal height for detecting IUGR (p < 0.0001).Ultrasound achieved sensitivity of 85% and specificity of 95.7%. It was found to be a highly accurate diagnostic method for IUGR (p < 0.0001). Conclusion:Clinical assessment with Ultrasound and Doppler will improve the detection rate of IUGR and may lead to significant decline in perinatal mortality and morbidity .