Role of Placental Localization and Uterine Artery Doppler as Predictors for Preeclampsia
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2017, Vol 5, Issue 8
Abstract
Abstract:Preeclampsia is a pregnancy specific syndrome of reduced organ perfusion secondary to vasospasm and endothelial activation. Several tests have been proposed to predict development of preeclampsia such as cold pressor test, isometric hand grip exercise, urinary calcium and plasma fibronectin. Studies have been shown that there is significant association between lateral placenta with presence of preeclampsia and abnormal uterine artery resistance. Among the various predictors for preeclampsia, localization of the placenta by ultrasound at 18-24 weeks is a very cost effective and noninvasive method, and has a good positive predictive value. Of our study is to find out relation of placental laterality and uterine artery resistance in prediction of preeclampsia. This Prospective observational study comprises 500 antenatal cases of Singleton, primi gravida at 18 to 24 weeks with complete follow-up till delivery. After recording of Blood pressures, Location of the placenta was determined by ultra-sonography. Lateral placenta was considered, only when 75% or more of the placental mass located on either side of the uterine cavity. All patients with lateral placenta were evaluated by Pulse Doppler to find out the uterine artery resistance index .Uterine artery RI > 0.58 and persistence of pre diastolic notch in the dominant side, taken as significant. In study of 500 cases, 18% had lateral placenta, while remaining had central placenta on ultra sound examination. Incidence of preeclampsia was approx 38% in lateral placenta. Out of these lateral placenta patients 34% had raised uterine artery RI and among them 83.8% developed preeclampsia. Raised uterine artery resistance in relation to preeclampsia exhibited high sensitivity of 83%, specificity of 86.4%, and positive predictive value of 76.4% and negative predictive value of 91.3%. Ultra-sonography is a simple, easy and cost effective diagnostic tool to predict high risk antenatal cases. Our study suggests that incidence of preeclampsia is more in patients with lateral placenta and its sensitivity and specificity increases significantly, when it is combined with uterine artery Doppler study. Keywords:Ultra sonography, Pre-eclampsia, PIH, Placental localization, Placental laterality, Central placenta, Color Doppler, Resistive Index
Authors and Affiliations
Sheetal Singh
Keywords
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