Compliance-weight deficit index. Combining umbilical artery resistance and growth deficit for predicting intrauterine growth retardation and poor perinatal outcome.

Overview

One hundred sixty-six patients underwent examination of the umbilical artery (UA) by continuous wave Doppler ultrasound one week prior to delivery. The UA compliance deficit (CD) and weight deficit (WD) were combined into an index (CWDI) by a formula based on the Pythagorean Theorem. CWDI represents the hypotenuse, and CD and WD represent the two perpendicular lines of a triangle: (CWDI = square root of CD2 + WD2). Perinatal outcomes were evaluated by the number of perinatal deaths, delivery for fetal indications prior to 37 weeks' gestation, five-minute Apgar score < 7, neonatal intensive care unit (NICU) admission and the presence of intrauterine growth retardation (IUGR). A CWDI value of > or = 20 was the most discriminatory in identifying fetuses with poor outcomes. Fetuses with CWDI > or = 20 were more likely to be premature (P < .001) or growth retarded (P < .001) or have lower Apgar scores (P < .005) and longer NICU stays (P < .001). Seven of the eight perinatal deaths occurred in patients with abnormal CWDI (P < .001). The sensitivity of an abnormal CWDI was 95% for IUGR, 60% for preterm delivery, 82% for NICU admission, 90% for Apgar score < 7 at five minutes, 87% for perinatal mortality and 68% for overall poor perinatal outcomes. CWDI is a sensitive index for the identification of fetuses with IUGR and poor perinatal outcome.