UTERINE ARTERY DOPPLER IN PREDICTION OF PRE-ECLAMPSIA DURING PREGNANCY

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UTERINE ARTERY DOPPLER IN PREDICTION OF PRE-ECLAMPSIA DURING PREGNANCY

Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 24

Abstract

BACKGROUND Uterine artery represents the major portion of the anterior division of the internal iliac artery during pregnancy. 1 In second trimester of pregnancy, uterine blood flow increases from 50 ml/min in the non-pregnant woman to over 700 mL/min. During normal pregnancy, the diastolic component of the uterine artery doppler wave form is thus transformed from one of low peak flow velocity and an early diastolic notch by 18-22 weeks. 2 The average increase in resistance index in the left and right uterine artery and its association with an early diastolic notch is found in patients, when there is impaired placentation. If early diastolic notch persists beyond 24 wks. of pregnancy, then this indicates a severe adverse outcome in both mother and foetus defined by intra uterine growth restriction and foetal asphyxia that may be followed by pre-eclampsia and foetal death. 3 Aims and Objectives- The aim of this study was to identify pre-eclampsia during present and subsequent pregnancies by screening of placental insufficiency by uterine artery Doppler. MATERIALS AND METHODS Pregnant mothers were recruited from antenatal outpatient department of R. G. Kar. Medical College & Hospital. Both normotensive and hypertensive pregnant mothers were included in study. Pregnant mothers with multiple gestations, congenital anomalies and preterm deliveries were excluded from the study. In this study, two-stage screening test of uterine arteries was done by pulsed wave doppler, one at 14-18 wks. and the other at 26-28 wks. of gestation. In the wave of both uterine arteries, an early diastolic notch was also carefully observed. Mothers were followed up to the delivery to observe pre-eclampsia. Sensitivity, specificity, positive predictive value & negative predictive value of pre-eclampsia were calculated according to the resistance index. RESULTS In our study, 40% of pregnant mothers were primigravidas and 60% were multigravidas. The sensitivity, specificity, PPV and NPU of pre-eclampsia are 66.6%, 89.3%, 28.5%, and 97.5% respectively. CONCLUSION A higher risk of developing pre-eclampsia is seen in pregnant women with an early diastolic notch after 24 wks. of pregnancy. There is association between increased impedance to flow in the uterine arteries with increased risk for subsequent development of pre-eclampsia.

Authors and Affiliations

Sukharanjan Howlader, Santanu Das

Keywords

EP ID EP563645
DOI 10.18410/jebmh/2018/377
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