Fetal Cerebral Umbilical Doppler Ratio in Prediction of Adverse Perinatal Outcome in Patient with Preeclampsia
Journal Title: Journal of Medical Science And clinical Research - Year 2014, Vol 2, Issue 6
Abstract
Objectives: This study was undertaken to evaluate the role of middle cerebral to umbilical artery blood velocity waveform's systolic/diastolic ratio (MCA/UA) and compare with biophysical profile as a predictor of adverse perinatal outcome in a patient complicated with pre eclampsia. Methods: In this prospective cross sectional study 100 gravid women complicated with preeclampsia in 3rd trimester fulfilling the selection criteria was taken for study. Thorough history taking with general, obstetric and pelvic examination & routine and special investigation was done. The periodic follow up was performed using non Stress Test (NST), amniotic fluid index (AFI ), umbilical artery resistance index (UARI), middle cerebral artery resistance index (MCARI) and MCA/UA ratio. MCA/UA <1, non reactive NST, AFI <5 were considered abnormal. The results of the ratio, and biophysical profile were evaluated to find out the best predictor of adverse perinatal outcome (APO) defined as perinatal mortality, caesarean delivery for fetal distress, admission to the neonatal intensive care unit (NICU), Apgar score <7 at 5 minute. Results: Among all the antepartum surveillance tests, MCA/UA Doppler ratio had found the highest sensitivity ( 72.97%), specificity 95.24%), Positive Predictive Value (PPV) (90%), Negative Predictive Value (NPV) (85.71%) for prediction of adverse perinatal outcome in pregnancies complicated with pre eclampsia. Conclusions: The MCA/UA was found the best predictor of adverse perinatal outcome in patients complicated with pre eclampsia. When the ratio was <1, fetal prognosis was poor.
Authors and Affiliations
Dr. Souvik Kumar Das
Keywords
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