Keywords : Diastolic notch
ROLE OF UTERINE ARTERY DOPPLER AT 11 TO 16 WEEKS OF GESTATION IN PREDICTION OF PREECLAMPSIA : AN OBSERVATIONAL STUDY
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 4, Pages 2160-2172
Background: Pre-eclampsia is a major cause of perinatal and maternal morbidity and mortality. Doppler is a non-invasive method for evaluation of feto-placental circulation without affecting pregnancy. A high resistance index in uterine artery Doppler waveform has been shown to be the best non-invasive screening test.
Aims: The aim of the study is early prediction of pre-eclampsia and its obstetrical outcome by transvaginal uterine artery Doppler at 11-16 weeks of gestation.
Materials and methods: It is a Observational study in 100 Pregnant Women between 11-16weeks of gestational age . After an informed consent women were subjected to transvaginal ultrasound for dating scan during which uterine artery Doppler waveforms were taken. These women were further followed up clinically for development of preeclampsia. Uterine artery Doppler were studied in all 100 cases.
Results: About 17 women developed preeclampsia among 100 women. Uterine artery notch is seen in 38% of women at 11-16 weeks and about 28.94% of women with notch at 11-16weeks developed preeclampsia. In preeclamptic women mean PI at 11-16 week is 2.6241 which is statistically highly significant as compared to normotensives ( p<0.0001) and hence this will help in prediction preeclampsia. Uterine artery notching at 11- 16 weeks gestation had 64.70% sensitivity and 90.32% NPV. PI > 95th centile at 11-16 weeks has sensitivity of 82.35% and NPV by 96.05%. When maternal risk factors are considered along with PI> 95th centile sensitivity increased to 88.23% and NPV increased to 97.56%. Mean gestation age at delivery is 33+6 week in preeclamptics and 38+5 week in normotensives ,47% had full term vaginal delivery, 9% had preterm vaginal delivery and 15% had preterm caesarean delivery and 29% had term caesarean delivery. Mean birth weight is 2.04kg in preeclamptics and 3.08kg in normotensives, mean Apgar at 1 min is 7.44 and at 5 min is 9.31. In preeclamptic women 7 babies were associated with IUGR and 1 IUFD. Mean duration of NICU stay is 36hrs.
Conclusion: Uterine artery Doppler studies between 11-16 weeks has high NPV, they help us to categorize our patients into low risk and high risk so that proper vigilance may be done in high risk women along with prophylactic aspirin therapy for improving maternal morbidity and mortality.