COMPARISON OF EARLY NEONATAL OUTCOME IN PREGNANT FEMALES FOR ASYMMETRICAL IUGR WITH NORMAL AND ABNORMAL UMBILICAL ARTERY WAVE FORMS: A CROSS-SECTIONAL STUDY

Background: Intrauterine growth restriction (IUGR) remains a major cause of perinatal morbidity and mortality, especially in developing countries. Early identification of fetuses at risk through Doppler ultrasonography enables timely intervention to prevent adverse outcomes. Umbilical artery waveform analysis serves as a key functional assessment of placental resistance and fetal well-being. Despite advancements, limited local data exist correlating abnormal Doppler findings with early neonatal outcomes in asymmetrical IUGR pregnancies. Objective: To determine the frequency of early neonatal outcomes in asymmetrical intrauterine growth restriction and to compare these outcomes between fetuses with normal and abnormal umbilical artery waveforms. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, Hilal-e-Ahmar Maternity Hospital, Faisalabad, from June to December 2023. A total of 160 pregnant women aged 20–35 years with singleton pregnancies of ≥24 weeks, meeting sonographic criteria for asymmetrical IUGR, were enrolled through non-probability consecutive sampling. All participants underwent Doppler ultrasonography to evaluate umbilical artery waveforms. Based on resistance index (RI), women were categorized as having normal (RI < 0.65) or abnormal (RI > 0.65) Doppler results. Neonatal outcomes including preterm birth, neonatal death, respiratory distress syndrome (RDS), NICU admission, and low APGAR scores at 5 minutes were recorded and analyzed using SPSS version 25, with p ≤ 0.05 considered significant. Results: The mean maternal age was 27.75 ± 4.56 years, and the mean gestational age at delivery was 37.06 ± 1.99 weeks. Among 160 neonates, 33 (20.6%) died, 66 (41.3%) developed RDS, 71 (44.4%) required NICU admission, and 116 (72.5%) had low APGAR scores. Abnormal umbilical artery waveforms were observed in 77 (48.1%) infants. A statistically significant association was noted between abnormal Doppler findings and neonatal death, RDS, and NICU admission (p < 0.05). Conclusion: Abnormal umbilical artery waveforms are significantly associated with adverse neonatal outcomes, confirming their prognostic importance in IUGR management. Routine Doppler evaluation should be incorporated into antenatal screening to guide clinical decision-making and improve perinatal outcomes.