Role of Doppler indices of umbilical and middle cerebral artery in prediction of perinatal outcome in preeclampsia

Authors

  • Padmini C. P. Department of Obstetrics & Gynaecology, Sri Siddhartha Medical College, Agalkote, Tumkur, Karnataka, India
  • Priyanka Das Department of Obstetrics & Gynaecology, Sri Siddhartha Medical College, Agalkote, Tumkur, Karnataka, India
  • Chaitra R. Department of Obstetrics & Gynaecology, Sri Siddhartha Medical College, Agalkote, Tumkur, Karnataka, India
  • M. Sriram Adithya Department of Obstetrics & Gynaecology, Sri Siddhartha Medical College, Agalkote, Tumkur, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20160596

Keywords:

Preeclampsia, IUGR, Doppler, UA, MCA

Abstract

Background: Hypertension which develops de novo in pregnancy appears to be unique to human and continue to be a major cause of reported perinatal mortality. The aim and objectives of the study was to evaluate the diagnostic value of Umbilical and Middle cerebral artery Doppler in predicting the perinatal outcome in preeclampsia.

Methods: A prospective study at Sri Siddhartha Medical College and Hospital between October2013-September2015 on 80pregnant women with preeclampsia at >30weeks gestation. Studies of fetal vessels were performed using a pulsed Doppler ultrasound. Resistance Index (RI), Pulsatility Index (PI) and systolic/diastolic ratio (S/D) were measured in umbilical artery (UA) and Middle cerebral artery (MCA) and perinatal outcomes were monitored and statistically analyzed.

Results: Out of 80 cases studied, 25 cases showed adverse perinatal outcome, among which 6 cases with perinatal death, 13 cases had low APGAR at 5minutes. 6 cases had NICU admission.

Conclusions: Color Doppler has an important role in antepartum fetal surveillance in preeclampsia which can detect fetal compromise at an early stage. In our study pulsatility index of umbilical artery and ratio of MCA/UA PI was more sensitive than other parameters with PPV 78%.

References

Singh BM, Mishra R. Hypertensive disorders in pregnancy. Ian Donald’s Practical Obstetric Problems. 6th edition. 2012:280-310.

Cunningham FG, Hauth JC, Leveno KJ, Gilstrap L, Bloom SL, Wenstrom KD. Obstetrical Complications: Pregnancy hypertension. In: Williams Obstetrics. 23rd ed USA: McGraw Hill. 2010:706-756.

Singh M, Sharma A, Singh P. Role of Doppler indices in the prediction of adverse perinatal outcome in preeclampsia. NJMR. 2013;4(3):315-8.

Arora D, Desai S. Significance of umbilical artery velocimetry in perinatal outcome of growth restricted fetuses. 2005;55(2):138-43.

Berg CJ, Chang J, Callanghan WM, Whitehead SJ. Pregnancy related mortality in the United States, 1991-1997. Obstet Gynecol. 2003;101(2):289-96.

Villian J, Carroli G, Wojdyla D, Abalos E, Griordano D, BA’qeel H, et al. Preeclampsia, Gestational hypertension and intrauterine growth restriction, related or independent condiyions? Am J Obstet Gynecol. 2006;194(4):921-31.

Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Am J Obstet Gynecol. 2003;102:181-92.

Neilson JP, Alfirevic Z. Doppler ultrasound for fetal assessment in high risk pregnancies. Cochrane Database Syst Rev. 2000;(2):CD000073.

Long PA, Oats JN. Preeclampsia in twin pregnancy- Severity and pathogenesis. Aust New Zealand. J Obstet Gynecol. 1987;27:1-5.

Andersch B, Srensson A, Hanson. Characterisctics of hypertension in pregnancy. Acta Obstet Gynecol Scand. 1984;118:33-8.

Bhatt CJ, AroraJ, Shah MS. Role of color Doppler in pregnancy induced hypertension. Indian J Radiol Imaging. 2003;13:417-20.

Hazra SK, Dash KK, Chaudhuri A. A prospective study of doppler velocimetry in pregnancy induced hypertension in a rural population of a developing country. 2013;2(2):127-31.

Gramellini D, Folli MC, Raboni S, Vadora E, Meriadi A. Cerebral umbilical Doppler Ratio as a predictor of adverse perinatal outcome. Obstet Gynecol. 1992;79:416-20.

Arudini D, Rizzo G. Prediction of fetal outcome in small for gestational age fetuses: comparison of doppler measuremnts obtained from different fetal vessels. J Perinat Med. 1992;20:29-38.

Kassanor D, Siristatidis C, Vitorates N, Salamalekis E, Creatas G. The clinical significance of Doppler findings in fetal middle cerebral artery during labour. J Obstet Gynecol report Biol. 2004;23:442-5.

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Published

2017-02-23

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Original Research Articles