Aim: To propose optimal management of intrauterine growth restriction
(IUGR) cases associated with severe preeclampsia at 28-34 weeks of
gestation. Methods: Two hundred pregnant women with severe
preeclampsia associated with growth restricted fetuses were followed
with doppler velocimetry of umbilical artery between 28-34 weeks of
pregnancy. Patients were grouped according to indications for
termination of pregnancy, first group consisted of severely affected
doppler velocity waveforms (n:100) and the second group consisted of
those whose cardiotocography and biophysic profile were unfavorable
(n:100). Groups were compared according to perinatal outcomes (cesarean
rates, gestational age at delivery, birth weight, Apgar scores and
demand for intubation and perinatal deaths). Results: The diagnosis
to delivery interval is significantly higher in the second group
(p<0.05), whereas there was no significant difference between groups
regarding gestational age at delivery and parity (p>0.05). Apgar
scores were lower in the first group (p<0.05), and there was
increased demand for intubation. Perinatal deaths were also lower in
the second group (p<0.05). Cesarean rate was significantly lower
compared with first group (p<0.05). Conclusion: Assessment of
doppler velocimetry alone may not be enough at decision for termination
of pregnancy, biophysic profile and cardiotocography should be added to
confirm exact time for delivery of a premature fetus and to improve
perinatal outcomes
