الفهرس 
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Abstract
Ultrasound biometry combined with multi vessel Doppler ultrasound provides better evaluation of clinically suspected cases of IUGR.
IUGR is defined as an EFW or AC less than the 10th centile. IUGR is noted to affect approximately 10-15 % of pregnant women. It is very important for obstetricians and perinatologists to identify growth-restricted fetuses, because this fetal condition is associated with significant perinatal morbidity and mortality.
There are multiple causes of IUGR, maternal as low socioeconomic status, extremities of age, race, maternal malnutrition, smoking, living in high attitude, multiple pregnancy, maternal disease, short inter-pregnancy period, drug abuse, and prior history of IUGR, fetal as congenital malformation, intrauterine infection, multiple pregnancy and genetic disorders and placental causes as placental insufficiency and abnormal placentation.
Antenatal diagnosis of IUGR decreases the fetal morbidity and mortality that complicate IUGR. Accurate dating is the most important step. Other important steps are identification of the risk factors, monitoring of the AC and EFW and fetal well-being.
IUGR has early complications as increase rate of preterm labor, intrauterine fetal death, stillbirth, respiratory distress syndrome and enterocolitis. The late complications include increase the risk for hypertension, type 2 diabetes mellitus, neurodevelopmental disorders and renal diseases.
Imaging is the most important modality in the management of IUGR; we can diagnose with 2 D ultrasound and choose the best for management by Doppler ultrasound.
Umbilical artery indices were significantly raised in IUGR pregnancy. While there are reduced mean middle cerebral artery indices in IUGR pregnancy.
Conclusion:
Doppler study of the umbilical artery is highly sensitive in the detection of IUGR while MCA Doppler is very useful for the prediction of adverse perinatal outcome in small for gestational age. Therefore, in high-risk pregnancies, Doppler assessment of umbilical and middle cerebral artery is useful in predicting fetuses with neonatal wasting. There is significant association between Doppler waveform analysis and the clinical outcome. The availability of Doppler studies lead to better obstetrics decision making.