Role of Uterine Artery Doppler to Predict Pregnancy Induced Hypertension and Intrauterine Growth Restriction (original) (raw)
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Role of Uterine Artery Doppler as a Predictor of Preeclampsia
Journal of Evolution of Medical and Dental Sciences, 2016
, which is a tertiary care centre. Duration of the study conducted was one year. Pregnant women attending antenatal OPD's who were willing to participate in the study were included. METHODS This is a prospective study. Total 250 antenatal patients were included. These patients were offered ultrasound examination at 11 to 14 weeks of gestational period. Left and right uterine artery was examined by colour and pulsed Doppler. Mean Pulsatility Index and presence of diastolic notch if any was noted. These patients were followed for occurrence of preeclampsia or any other complication. Pregnancy outcome in both the group was studied. Risk ratio was calculated. STATISTICAL ANALYSIS Pearson's Chi Square test or Fisher's exact test is used to study categoric variables and unpaired 't' test is used for studying continuous variables. Thus normal and abnormal Doppler results with incidences of preeclampsia and its complications were studied. Abnormal results in terms of more than 95 th percentile of pulsatility in sex and presence of bilateral uterine notch noted. Risk ratio were calculated. RESULT In 96% of the patients, satisfactory uterine artery Doppler waveform was noted. All the patients were followed till date of delivery to study pregnancy outcome and occurrence of preeclampsia or related complications if any; 95 th centile of mean pulsatility index obtained was 2.35 which is constant with gestational age. Patients with abnormal uterine artery Doppler at 11-14 weeks had more incidences of preeclampsia (RR-3.5), intrauterine growth restriction (RR-3) and related complications (RR-5.8) than patients with normal Doppler. CONCLUSION Our study noted that the patients with preeclampsia and associated complications had uterine artery Doppler changes in ultrasound study done at 11 to 14 weeks. So we conclude that the Doppler study done at earlier gestational age is useful in predicting preeclampsia in later gestational period.
Prediction of Preeclampsia by Uterine Artery Doppler at 20-24 Weeks' Gestation
Fetal Diagnosis and Therapy, 2013
was above the 95th percentile (1.509 MoM) in 72.7, 36.1 and 14.9% of cases of PE requiring delivery at <34, 34-37 and ≥ 38 weeks, respectively, and the percentages for PE with SGA were 80.2, 55.6 and 37.4%. Conclusions: In a normal pregnancy, uterine artery PI is affected by maternal characteristics, and in PE, uterine artery PI MoM is related to the severity of the disease.
Indian Journal of Obstetrics and Gynecology Research
This study was carried out to determine the validity and reliability of Uterine Artery (UtA) Doppler imaging as a screening tool for predicting preeclampsia among pregnant women attending a tertiary care hospital of the Armed Forces in second trimester.Our study was a prospective diagnostic study carried out in 680 pregnant women (age group of 19 to 30 years) in second trimester. Maternal BP was recorded using automated BP apparatus on three occasions (15 minutes apart) in supine posture. This was followed by uterine artery Doppler with measurement of Resistivity index (RI) and Pulsatility index (PI). Patients were followed up every month till 12 weeks post-partum. Statistical analysis was done using SPSS version 21. The mean uterine artery PI was 1.21±0.296 and the mean uterine artery RI value was observed to be 0.58±0.18. The incidence of preeclampsia among the study participants was observed to be 9.9%. The mean uterine artery PI and RI among patient with preeclampsia was found t...
Role of Uterine Artery Doppler in Prediction of Pre Eclampsia And Its Foetal Outcome
Introduction: Preeclampsia during pregnancy is one of the major risk factors for maternal and fetal mortality in developing countries. After implantation in the uterine cavity, the arterial system that irrigates the endometrium and myometrium undergoes a series of changes which lead to the uteroplacental circulation. Such changes in the arterial system are a result of the deciduas invasion by the trophoblast. So uterine artery Doppler has become common in evaluation and management of pregnancy associated complication like fetal growth restriction. Aim:To known the role of Doppler study in prediction of preeclampsia and its outcome on maternal and fetal risk factors. Materials And Methods: 55 pregnant women who were more than 18 weeks included into study, with risk factors like family history of hypertension and previous history of preeclampsia , eclampsia, abruption, twins, etc except with women who were chronic hypertension and less than 18 weeks not
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: To evaluate the value of one step uterine artery Doppler and maternal history in the prediction of early onset pre-eclampsia and intra uterine growth restriction in a random population Methods: This study was conducted from 2012 to 2014 Lalla Ded hospital which is a tertiary care hospital associated with GMC Srinagar. This was a prospective study conducted on 200 pregnant women in the second trimester between 19-22 weeks of gestation. Singleton pregnant women were recruited from those attending antenatal care clinics at this hospital over a period of two years. Obstetric and medical history was taken. Transabdominal ultrasound was done and then patients were subjected to Doppler examination of uterine arteries. Results: Mean age of study population was 26.3 years with maximum number of patients in 25-29 year age group. Total numbers of primigravida were 59.5%. Maternal history revealed that 9.5% had previous history of hypertensive pregnancy, 3.5% had history of IUGR. Early onset pre-eclampsia (<32 weeks) was present in 42.9% and late onset pre-eclampsia (>32 weeks) was present in 57.1% cases. Doppler abnormalities were present in 7.5%. In the patients who developed pre-eclampsia 57.1% had uterine artery Doppler abnormalities. Conclusions: Maternal history and uterine artery Doppler at 19-22 weeks gestation is a single step test for the prediction of early onset(<32 weeks) and late onset pre-eclampsia and intra uterine growth restriction.
Obstetrics and gynecology international, 2009
Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR). Methods. A prospective multicentre study that included all women with singleton pregnancies at 19-22 weeks of gestation (w). The mean pulsatility index (mPI) of both uterine arteries was calculated. Receiver-operating characteristics curves (ROC) were drawn to compare uterine artery Doppler and maternal risk factors for the prediction of early-onset PE and/or IUGR (before 32 w) and late-onset PE and/or IUGR. Results. 6,586 women were included in the study. Complete outcome data was recorded for 6,035 of these women (91.6%). PE developed in 75 (1.2%) and IUGR in 69 (1.1%) cases. Uterine Doppler mPI was 0.99 and the 90th centile was 1.40. For 10% false-positive rate, uterine Doppler mPI identified 70.6% of pregnancies that subsequently developed early-onset PE and 73.3% of pregnancies that developed early-onset ...
Role of Uterine Artery Doppler Ultrasound in Predicting Pre-Eclampsia in High-Risk Women
Cureus
Background and objective Pre-eclampsia (PE) is a major cause of maternal morbidity and mortality. The utility of Doppler ultrasonography (U/S) in predicting PE has not been extensively explored. This study aimed to determine the role of Doppler U/S in predicting PE among high-risk women. Methodology This was a retrospective observational study conducted at the Department of Obstetrics and Gynecology of Abbasi Shaheed Hospital in Karachi, over a period of one year, from January 2019 till December 2019. A total of 325 women were initially screened for risk factors for PE. Among them, 75 women were eventually found to have risk factors for PE and hence included in the study. Uterine artery Doppler U/S was performed to evaluate uterine artery's flow velocity waveforms. They were then used to calculate the presence of diastolic notch and resistance index (RI). At each antenatal visit, the risk factors for PE such as BP, proteinuria, and signs and symptoms were noted. Women were labeled to have PE if they developed hypertension (BP >140/90) after 20 weeks of gestation in combination with proteinuria. Results Twenty women (28%) had a normal Doppler flow of the uterine arteries. In 54 (72%) women, a unilateral/bilateral RI >0.58 was observed, and 29 women (38.7%) had a bilateral Rl >0.58. Notching of the uterine artery was also observed in 42 (26.7%, unilateral/bilateral) and in 22 (29.3%) bilaterally. Among the 75 women, BP of 140/90 mmHg along with proteinuria was observed in 56 (76.7%) cases, which were hence diagnosed as PE. Based on the cutoff of Rl and notching of the uterine artery, the overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of Doppler U/S in predicting PE were 71.4%, 26.3%, 23.8%, and 74.1%, respectively. As far as individual Doppler U/S indices were concerned, RI >0.58 (unilateral/bilateral) was found to be most sensitive (71%), while the presence of uterine artery notch (unilateral/bilateral) was most specific in predicting PE. Conclusion Abnormal Doppler U/S has good overall sensitivity in predicting PE. Among individual Doppler indices, notching of uterine arteries had a better specificity compared to high RI.
Uterine Artery Doppler in the Prediction of Preeclampsia and Adverse Pregnancy Outcome
Donald School Journal of Ultrasound in Obstetrics & Gynecology, 2009
Preeclampsia and fetal growth restriction are major causes of perinatal mortality and morbidity. Several studies have shown that a generalized endothelial dysfunction is associated with these complications. Clinical trials have shown that pregnant women who demonstrate high resistance in uteroplacental blood flow are at higher risk for preeclampsia. Uterine artery Doppler studies both in the second and the first trimester can predict pregnancies at increased risk of the complications of impaired placentation. The sensitivity for predicting severe preeclampsia ranges between 80 and 90% for a false positive rate of 5 to 7%. Uterine artery Doppler screening at 20 to 24 weeks’ gestation is superior to first trimester screening, and appears to fulfill the requirements for a worthwhile screening test. Further research is needed to better assess the value of various combinations of uterine artery Doppler and maternal serum markers, for the prediction of adverse pregnancy outcome.
Role of Uterine Artery Doppler in 11-14 Weeks Scan as a Predictor of Preeclampsia
Annals of International Medical and Dental Research, 2017
Background: Preeclampsia (PE) is a disease in pregnancy involving interplay of multiple genetic, immunologic and environmental factors. The primary pathology of PE is related to abnormal placentation. Uterine artery doppler in the first trimester is a promising screening test for prediction of PE. Objective: To study the role of first trimester uterine artery doppler in prediction of preeclampsia. Methods: A prospective study was carried out to evaluate the role of uterine artery doppler in the 11-14 week scan for prediction of preeclampsia and associated IUGR. A total number of 200 women who met our selection criteria were included in the study. Uterine artery doppler was done as part of the 11-14 weeks scan and mean uterine artery PI was calculated. Results: Among the women in the study, PE was detected in 21 women with incidence of 11 %. The sensitivity, specificity, positive predictive value and negative predictive values of mean uterine artery PI for development of PI were 76%, 86%, 39% and 96% respectively. Conclusions: Early identification of pregnancies at high-risk of early onset PE and undertaking the necessary measures to improve placentation can reduce the burden of the disease by using prophylactic aspirin. Effective screening for early onset PE can be achieved in the firsttrimester of pregnancy with maternal history, uterine artery doppler and biochemical markers. Biochemical screening for preeclampsia needs to become cheaper and easily accessible for better prediction of PE in first trimester.
Gynecology & Obstetrics, 2014
Objective: To evaluate the prognostic role of uterine artery Doppler for pre-eclampsia in high-risk patients. Because of the higher prevalence of new onset of disease in a high-risk population, a better performance could be expected in this special group. Methods: This retrospective study compares uterine artery Doppler to predict pre-eclampsia in patients with a history of pre-eclampsia and also in patients with chronic hypertension, both with high-risk to develop recurrent, superimposed or new onset pre-eclampsia. Doppler measurements of uterine arteries were performed every 4 weeks in the 1 st and 2 nd trimester. Results: Pre-eclampsia occured in 33% of current high-risk pregnancies. The best performance for the prediction of pre-eclampsia was provided by bilateral notching plus increased PI ≥ 2.5, both in the 1 st and 2 nd trimester. In the 1 st trimester the specifity was 81% (95% CI: 58-95) in the Prior PE group and 95% (95% CI: 74-100) in the C. H. group. In the 2 nd trimester the sensitivity was 97% (95% CI: 86-100) in the Prior PE group and 100% (95% CI: 93-100) in the C. H. group. Sensitivity was very low in the 1 st and 2 nd trimester. Conclusion: Our results show, that the negative predictive value of uterine artery Doppler works well even in a high-risk group. Data however suggest relative poor positive predictive value of uterine artery Doppler even in a high-risk population using a cutoff of 2.5 PI. A value of the uterine artery Doppler using a high cutoff might be in the increased specifity. Nevertheless, a combination of the uterine artery Doppler with biochemical markers and maternal parameters seems to be essential.