The ability of continuous-wave Doppler ultrasound to detect fetal growth restriction

PLoS One. 2021 Aug 9;16(8):e0255960. doi: 10.1371/journal.pone.0255960. eCollection 2021.


Background: Fetal growth restriction (FGR), defined as a fetus failing to reach its genetic growth potential, remains poorly diagnosed antenatally. This study aimed to assess the ability of continuous-wave Doppler ultrasound of the umbilical artery (CWD-UmA) to detect FGR in healthy women with low-risk pregnancies.

Methods and findings: This prospective longitudinal descriptive cohort study enrolled infants born to low-risk mothers who were screened with CWD-UmA between 28-34 weeks' gestation; the resistance index (RI) was classified as normal or abnormal. Infants were assessed at 6, 10, 14 weeks, and 6 months postnatally for anthropometric indicators and body composition using the deuterium dilution method to assess fat-free mass (FFM). Neonates in the abnormal RI group were compared with those in the normal RI group, and neonates classified as small-for-gestational age (SGA) were compared with appropriate-for-gestational age (AGA) neonates. Eighty-one term infants were included. Only 6 of 26 infants (23.1%) with an abnormal RI value would have been classified as SGA. The abnormal RI group had significantly reduced mean FFM and FFM-for-age Z-scores at 6, 10, 14 weeks, and 6 months compared with the normal RI group (P<0.015). The SGA group's FFM did not show this consistent trend when compared to AGA FFM, being significantly different only at 6 months (P = 0.039). The main limitation of the study was the small sample size of the infant follow-up.

Conclusions: Abnormal RI obtained from CWD-UmA is able to detect FGR and is considered a useful addition to classifying the neonate only by SGA or AGA at birth.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Fetal Growth Retardation / diagnosis*
  • Fetal Growth Retardation / diagnostic imaging
  • Fetal Growth Retardation / epidemiology
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age / growth & development*
  • Longitudinal Studies
  • Pregnancy
  • Prospective Studies
  • Ultrasonography, Doppler / methods*

Grants and funding

The antenatal part of this study (CWD-UmA screening) was funded by the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a cosponsored program executed by the World Health Organization. The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript for the infant's postnatal assessment.