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Research Paper | Medicine | India | Volume 12 Issue 5, May 2023 | Rating: 5.3 / 10
Screening and Prediction of Preeclampsia with Uterine Artery Doppler
Dr. Rujuta Fuke [3] | Dr. Deepa Ankushe
Abstract: Introduction: Hypertensive disorder of pregnancy (HDP) is among three leading causes of maternal mortality and morbidity. Pathophysiology of preeclampsia helps in understanding the use of ultrasonography doppler in its prediction when performed in first trimester during establishment of placental circulation. Resistance to the blood flow within uteroplacental circulation transmitted upstream to the uterine arteries can be measured with the help of different indices. Indices of uterine artery doppler such as Pulsatility Index (PI), Resistivity Index (RI), ratio of peak systolic and diastolic velocity (SD ratio), presence and absence of diastolic notch in first and second trimester are used as screening test for prediction of preeclampsia; as they indicate resistance in placental circulation. Methodology: In this prospective, comparative, observational study, doppler ultrasound of the uterine arteries was performed at 11 to 13+6 and 18 to 22 weeks of gestation and the average Pulsatility index (PI) of the blood flow through both uterine arteries was measured and mean PI was calculated. Subjects were followed up regularly with us by clinical examination, estimation of fundal height, Mean Arterial Pressure (MAP), urine examination for proteinuria and early signs for the development of preeclampsia or intrauterine growth restriction at regular intervals like between 19 - 25 weeks, 30 - 35 weeks, 35 to 38 weeks and upto delivery. Result: Comparison for predictive value of first trimester Doppler with second trimester Doppler in development of pre - eclampsia revealed that the positive Predictive values of First trimester Doppler was 41.67% and negative predictive value of first trimester uterine artery doppler was 88.06%, the p value being 0.8907, which was not significant. Positive Predictive values of second trimester doppler was 40.91% and negative predictive value of first trimester uterine artery doppler was 92.98%, the p value being 0.087, which was significant. Conclusion: Hypertensive disorders of pregnancy including preeclampsia if diagnosed earlier, may cause help to avoid further complications. Abnormal Uterine artery doppler changes have been associated with subsequent adverse pregnancy outcomes like hypertensive disorders of pregnancy, intrauterine growth restriction and perinatal mortality. Two staged doppler screening helps in prediction of preeclampsia, in earlier stages and helps to avoid complications.
Keywords: Preeclampsia, Uterine Artery Doppler, UAD, Pulsatility index (PI), Mean Arterial Pressure, MAP
Edition: Volume 12 Issue 5, May 2023,
Pages: 1726 - 1733