Role of uterine artery doppler in prediction of pre-eclampsia

• Published in: International Journal of Reproduction, Contraception, Obstetrics and Gynecology Vol. 13; no. 6; pp. 1559 - 1562
• Main Authors: Patel, Jigisha I, Deliwala, Kruti J, Shah, Sapana R, Parikh, Purvi M
• Format: Journal Article
• Language: English
• Published: International Journal of Reproduction, Contraception, Obstetrics and Gynecology 01.06.2024
• Subjects: Diagnosis; Doppler ultrasonography; Obstetrical research; Physiological aspects; Preeclampsia; India
• ISSN: 2320-1770; 2320-1789
• DOI: 10.18203/2320-1770.ijrcog20241444

Background: Approximately 5-10 % of pregnancies are complicated by pre- eclampsia and it is a prime cause for maternal and perinatal mortality and morbidity worldwide, particularly in developing countries. In preeclampsia insufficient invasion of maternal spiral arteries by the trophoblast early in gestation due to abnormal implantation or maternal vascular disease results in impaired placental perfusion. Aspirin is a potent anti-inflammatory drug, has been shown to inhibit the biosynthesis and release of prostaglandins, even in low dosage. Ingestion of low dose aspirin may result in a decrease in the incidence of pre-eclampsia and fetal growth restriction and the precise mechanism by which it prevents preeclampsia in some women is also uncertain. Methods: The present prospective observational study was carried out in females between 18-20 weeks of gestation with raised uterine artery PI attending antenatal clinic in obstetrics and gynaecology department in SVP Hospital Ahmedabad from May 2023 to December 2023 using Microsoft excel and SPSS version 23. Results: In this study all the females were with raised uterine artery PI in 18-20 weeks ultrasound among them 51.85% were normotensive in later pregnancy. 48.14% developed pre-eclampsia in later pregnancy. In our study the middle cerebral artery indices in doppler ultrasound showed increased diastolic flow (including brain sparing effect) among 37% of the patients. The umbilical artery doppler showed that 62.9% of subjects were having normal umbilical artery indices, 18.5% of the patients were having decreased diastolic flow, 11.1% of the patients were having reversal of diastolic flow and 7.4% of the patients were having absent end diastolic flow Conclusions: Doppler study for fetal surveillance in pre-eclampsia is a very useful and non-invasive method and abnormal uterine artery velocimetry lead to the worse pregnancy outcomes in the present study. The knowledge of uterine and umbilical artery doppler is very helpful to improve pregnancy management and to identify and assess hypertensive disorder of the pregnancy at early gestational age compared to other antepartum test modalities. Keywords: Abnormal doppler indices, Pre-eclampsia, Low dose aspirin, Abnormal uteroplacental doppler flow