الفهرس 
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Abstract
Intrauterine growth restriction which affects up to 5-10% of pregnancies is a common complication of pregnancy thathas been associated with a variety of adverse perinatal outcomes increases the risks of intrauterinedemise, neonatal morbidity, and neonatal death.Furthermore, epidemiologic studies have revealed thatgrowth-restricted fetuses are predisposed to the developmentof cognitive delay in childhood and diseases inadulthood.
Small-for-gestational-age new-borns are predisposedto complications, including hypoglycaemia, hyperbilirubinemia, hypothermia, intraventricular haemorrhage, necrotizing enterocolitis, seizures, sepsis, respiratory distress syndrome, and neonatal death.
Fetal growth restriction (FGR) remains a leading contributor to perinatal mortality and morbidity and metabolic syndrome inlater life. Recent advances in ultrasound and Doppler have elucidated several mechanisms in the evolution of the disease.
There is no cure, and management is reliant on a structured antenatal surveillance program with timely intervention.
Developments in Doppler of the maternal and fetalcirculation, fetal heart rate analysis, and biophysical profile have improved the diagnosis of both FGR and SGA. SGA pregnancies often exhibit normal fetal Doppler, whilst FGR due to placental disease exhibits characteristic maternal and fetal Doppler abnormalities.
Investigation of fetal blood vessels with Doppler velocimetry, including assessments of the middle cerebral artery and the precordial venous system, has been explored in the setting of fetal growth restriction.
A preliminary study also reported that MCA PSV increased in a subset of IUGR fetuses, suggesting that it could be a good predictor of perinatal mortality.
Normal MCA Doppler finding may be useful to help identify small fetuses that are not likely to have a major adverse outcome with a reported negative predictive value of 86%. A high MCA PSV predicts perinatal mortality better than a low MCA-PI. It has been proposed that MCA-PSV might be valuable in the clinical assessment of IUGR fetuses that have abnormal umbilical artery.
The present study was designed to determine the role of MCA-PSV Doppler velociemetry to predict the perinatal outcomes in pregnancies complicated with fetal growth restrictions and to test the hypothesis that theMCA-PSV can provide additional information on theprognosis of hypoxemic IUGR fetuses and how this can help in triaging the patient to specific care in law resource settings.About 71 patients were enrolled in this study from the fetomaternal and high risk pregnancy outpatient clinics based at El-Minia maternity university hospital of the department of Obstetrics &Gynecology, withthe diagnosis of IUGR gestational age between 28-34 weeks of pregnancy. They were allocated into two groups, prospectively according to the value of MCA PSV either normal or above the 95th.