Patterns of Aortic Isthmus Doppler in Early Fetal Growth Restriction , and the Changes in Aortic Isthmus Doppler Parameters With Every Changes of Other Early Iugr Parameters Like EFW, Uterine Artery Doppler, Cerebroplacental Ratio and Ductus Venosus Doppler in Comparison With Normal Group .

June 27, 2026 updated by: Hanna Matta louize, Assiut University

Patterns of Aortic Isthmus Doppler in Early Fetal Growth Restriction, Cross Sectional Comparative Study

This study aims to evaluate the patterns of aortic isthmus Doppler in fetuses diagnosed with early fetal growth restriction (FGR) and to correlate these findings with the severity of FGR and other Doppler parameters.

A cross-sectional comparative observational study will be conducted on singleton pregnant women attending the fetal medicine unit at Assiut University Hospital. Participants will be divided into two groups: fetuses with FGR and normal controls.

Doppler measurements including aortic isthmus indices, uterine artery, umbilical artery, middle cerebral artery, cerebroplacental ratio, and ductus venosus will be assessed at a single time point. The study will help to clarify the clinical value of aortic isthmus Doppler in early detection and assessment of fetal compromise in FGR cases.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

Fetal growth restriction (FGR) is a major contributor to perinatal morbidity and mortality and is commonly associated with placental insufficiency. Early identification of fetal compromise remains a significant clinical challenge. Doppler assessment of fetal circulation has been widely used to monitor affected fetuses, including evaluation of the umbilical artery, middle cerebral artery, and ductus venosus.

The aortic isthmus represents a critical vascular junction reflecting the balance between cerebral and placental circulation. Changes in aortic isthmus Doppler patterns may provide early insights into fetal hemodynamic adaptation and deterioration in cases of FGR.

This cross-sectional comparative observational study will be conducted at the fetal medicine unit, Women's Health Hospital, Assiut University. The study population will include singleton pregnancies diagnosed with FGR (EFW <10th percentile) and a control group of normal fetuses.

Participants will undergo a single-time Doppler assessment including fetal biometry, uterine artery PI, umbilical artery PI, middle cerebral artery PI, cerebroplacental ratio, ductus venosus PI, and aortic isthmus Doppler indices. The aortic isthmus flow will be classified based on the isthmic flow index (IFI) into five categories, reflecting progressive hemodynamic changes.

The primary objective is to determine the correlation between aortic isthmus Doppler changes and the severity of FGR based on estimated fetal weight percentiles. Secondary objectives include correlation of aortic isthmus findings with cerebroplacental ratio and ductus venosus parameters.

This study is designed as a pilot exploratory study due to limited previous data. Results are expected to enhance understanding of fetal hemodynamics and potentially improve monitoring strategies in pregnancies complicated by FGR.

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Name: Hanna Matt Louize, Specialist
Phone Number: +201287618565
Email: hanna.matta0155@med.aun.edu.eg

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Singleton pregnant women attending the fetal medicine unit at Women's Health Hospital, Assiut University, including both fetal growth restriction cases and normal controls.

Description

Inclusion Criteria:

Singleton pregnancy
Diagnosis of fetal growth restriction (estimated fetal weight <10th percentile for gestational age)
Written informed consent obtained from the patient

Exclusion Criteria:

Major fetal structural anomalies, especially cardiovascular anomalies
Multiple pregnancy (e.g., twins)
Suspected chromosomal abnormalities or genetic syndromes
Severe maternal comorbidities affecting Doppler results (e.g., uncontrolled diabetes, lupus)
Uncertain gestational age
Fetal demise before Doppler assessment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
FGR Group Singleton pregnancies diagnosed with fetal growth restriction (estimated fetal weight less than the 10th percentile for gestational age), undergoing Doppler assessment including aortic isthmus and other fetal vessels.
Control Group Singleton pregnancies with normal fetal growth (estimated fetal weight above the 10th percentile), undergoing the same Doppler assessment as the FGR group for comparison.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Aortic Isthmus Pulsatility Index Time Frame: Day 1	Measurement of the aortic isthmus pulsatility index (PI) and its correlation with the severity of fetal growth restriction based on estimated fetal weight percentiles.	Day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Cerebroplacental Ratio Time Frame: Day 1	Measurement of cerebroplacental ratio (MCA PI / UA PI) and its correlation with aortic isthmus Doppler findings.	Day 1
Ductus Venosus Doppler Time Frame: Day 1	Assessment of ductus venosus pulsatility index and its relationship with aortic isthmus Doppler changes in fetal growth restriction.	Day 1
Uterine and Umbilical Artery Doppler Time Frame: Day 1	Evaluation of uterine artery and umbilical artery pulsatility indices and their association with aortic isthmus Doppler parameters.	Day 1
Isthmic Flow Index Time Frame: 1 day	Assessment of isthmic flow index (IFI) and its association with fetal hemodynamic changes in fetal growth restriction cases.	1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

June 1, 2028

Study Completion (Estimated)

June 1, 2029

Study Registration Dates

First Submitted

June 22, 2026

First Submitted That Met QC Criteria

June 27, 2026

First Posted (Actual)

June 30, 2026

Study Record Updates

Last Update Posted (Actual)