 Hello everyone, my topic of overall presentation is unraveling the fetal circulatory dynamics in the growth-restricted fetuses with impices on the granular circulation and the particular correlations. I am the president of the government Dr. Mahesh Mandir with my co-authors and affiliation to the Department of Operative Diagnosis at JNP Nappur Maharashtra. Am is an objective of the study to evolve the patterns of the fetal and circulation by a threat or doctor in cases of the fetal growth restriction. To investigate the interrelationship and correlation among the doctor measurements and acquire from the good and the adoptive while concretely assessing their incisors and gestational issues. As we all know the growth-restricted fetuses present a considerable clinical challenge marked by the compromised fetal growth and potential adverse outcomes. I am showing you the dynamics of the fetal circulation in the square-tool initiating these pregnancies. In cases of severe or severe cases of the fetal growth restriction, and there is a deviation of the normal growth criteria between the fetal and the developmental side disrupting the intricate process. We all know that the doctor does not need to understand the hemodynamic changes in the fetal circulation with the study integrates with the ultrasound imaging and including the fetal doctor to evaluate the fetal renaissance in the healthy, healthy and the growth-restricted fetuses. The primary focus was to establish the correlation between the fetal, fetal renaissance and the doctor and the fetal growth restriction and uncovering these correlations can provide insight into the physiological adaptations and impairment in the renal circulation linked to the fetal growth restriction. This cross-sectional study has happened during the September and on 2020-23, on November 2023 with Oman attending the ANC clinic of the OBGD Department of Agents in Akkur. We have included the singleton pregnancy between the 20 to 38 weeks of gestation with maternal age in between the 19 to 35 years with confirmation of the LMP by a patient. With the exclusion criteria includes the multiple pregnancies, uterine anvilis fetus with congenital anvilis fissure, anvilis and unclear renal margins. The examination we have here takes place on the Sampson-Haris-Atee-Eho machine with transducer of the 3.7 million-guards, caribbean and transducer. The participants in distribution includes the food for two months which is divided into the croupé and the croupé. The croupé consists of the fetal growth restriction and the croupé consists of the normal pregnancies. The gestationalized determination based on the day of the last menstrual period with further confirmed by the ultrasound scan. The assessment conducted and now conducted the fetal biometric and coladopter measurements including measurements such as the heart circumference and abdomen circumference, hemorrhage and isometrial birth fetal bed. With the on-dopter PI and RI measurements updated for the critical vessels including the renal arteries, MEMC, umbilical arteries, bilateral uterine arteries. The PI calculations we are now done using the ultrasound equipment built-in software. Here we can see the renal toplar, the fetal renal toplar with the PI RI values and the toplar waveforms. Here we can see the two-dimensional renal length and two-dimensional renal sizes. Results obtained from this study have summarized into the data groups of the croupé and the croupé with the mean standard deviation variance range and variance and range. What we completed from this study was the mean age group of the croupé approximately is higher which is 26 years and the mean age group of the patients of the 25 years. While the gestational age of the croupé shows a period range between the 32 weeks to 35 weeks while the croupé shows the 34 weeks to 35 weeks. The fetal kidney measurement showcases both similar average fetal kidney sizes for both the kidneys. PI and RI are of the fetal renal arteries. Here we measured the major trend where the croupé tends to have higher PI RI values for both the fetal arteries considered to the croupé. PI values of the MEMC and the umbilical arteries were found to be relatively higher than in the croupé than the croupé. How are these values? You mean within the normal percentage limits according to the fetal Barcelona calculator. The PI analysis, further PI analysis was done and for the both the kidneys, for the both the kidneys, the mean BI of the fetal renal artery in the croupé which is around 2.5 to 2.5. Which is higher than the croupé stating that there is a statistically significant with PI value less than 0.001. Here the RI values also calculated and the analysis of data values. Here we can see there is no significant difference in the resistance between the croupé and the croupé for both the kidneys despite the slight numerical difference. The correlation study has done for GA by LMP and the kidney sizes and there is a strong positive correlation in the both the croupé noted. As the gestational age increases, there is a simultaneous increase in the size of the kidneys which indicates a consistent relationship between the gestational age and fetal kidney sizes in both the croupé. It implies that the individual kidney sizes are not affected in the cases of the EFG. The growth seems to be proportional to the progression of the gestation. Discussion, as you know the fetal growth restriction has had a multiple influence by the multiple factors like the mass of the fetus and the placenta. We can diagnose the fetal growth restriction on the ultrasound if the fetal weight is less than 10%. It is small for AH and BAP and if it is less than 3%, it is the fetal growth restriction. It is characterized by the placental incisivity with leading to the circulatory adaptations. We had the study on the fetal renal circulation adaptation. So here the previous study indicates that the reduced renal perfusion linked to the inferior nephrogenesis in EFGR which highlights the connection between the ultraternal circulation and the fetal growth restriction. The renal RTPI in EFGR focuses on the PI of the major of the renal blood flow in the fetal growth restricted cases. There is early manifestation of the ultraternal artery flow restrictions before the kidney side changes. Here we can identify the renal perfusion indicated by the increased PI due to the fetal hypoxemia. These study findings conclude the strong difference in the renal RTPI values between the normal and abnormal group with the renal RTPI sensitivities. They can be used as early diagnostic marker for the compromised fetal renal circulation in EFGR and it also such as the potential area intervention and the management strategies. To conclude the study, the comparison between both the groups and the group A being exhibit higher PI values indicating the higher renal resistance and with the stronger correlation with the renal PI values in the group A. Study strength lies in the detail fetal and maternal measurements. But limited change lies in the sample size and the data which cause the data for new interpretations. We mainly can focus on the renal RTPI index which directly measures the renal blood flow and early changes in the flow resistance precedes notably in the kidney side differences which happened in the fetal growth restriction in less stages. It also detects the altered circulation and then the size changes. It shows the significant difference between the normal and the growth restricted fetal assist. Hence, the significance of the renal RTPI impasses its role as an early indicator of the altered renal circulation and its changes before the conventional of the markers and kidney sizes. It shows the importance of the timely intervention in managing the EFGR for the fit and better of the fetal outcomes. We can use this as a multi-parametric approach which is the promise in defining the diagnostic and monitoring strategies. The future direct use can be used to validate and extend this finding and potential for re-defining the pre-analysis practices for the high-respectancies. Here are the references for my study. Thank you.