Foetal Doppler Surveillance and Perinatal Outcome in Intrauterine Growth Restriction: A Prospective Study at Obafemi Awolowo University Teaching Hospital

Foetal Doppler surveillance of umbilical artery and middle cerebral artery blood flow is the cornerstone of intrauterine growth restriction (IUGR) management, enabling timed delivery decisions that optimise perinatal survival. This prospective study evaluates the relationship between Doppler surveillance findings and perinatal outcomes in IUGR pregnancies managed at Obafemi Awolowo University Teaching Hospital (OAUTHC), Ile-Ife, Osun State, South West Nigeria. A prospective cohort of 80 IUGR pregnancies confirmed by serial ultrasound and defined as estimated foetal weight below the 10th centile was enrolled between 28 and 36 weeks gestation. Two-weekly Doppler assessments of umbilical artery pulsatility index, middle cerebral artery pulsatility index, and cerebroplacental ratio were performed. Perinatal outcomes including gestational age at delivery, neonatal intensive care admission, APGAR scores, and perinatal death were recorded. Absent or reversed end-diastolic flow in the umbilical artery was documented in 26 percent and was associated with perinatal mortality of 31 percent compared to 4 percent in those with forward flow. Abnormal cerebroplacental ratio was the earliest Doppler change, preceding umbilical artery abnormalities in 63 percent of deteriorating cases. The study validates serial Doppler surveillance as a clinically useful management guide for IUGR at OAUTHC and recommends standardised Doppler-based delivery timing protocols. Keywords: foetal Doppler, IUGR, perinatal outcome, OAUTHC, umbilical artery