Assessment of color Doppler flow metric indices in first-trimester threatened abortion and to study their outcome at 20 weeks

Abstract

Background: Threatened abortion is one of the major problems in obstetrics and applies to one-third of all pregnancies. Aims and Objectives: The aim of the study was to study the color Doppler flow metric indices of spiral artery blood flow in the first trimester (6–10 weeks) in cases of threatened abortion and normal pregnancies and to study their outcome at 20 weeks. Patients and Methods: Spiral artery was sonographically evaluated in 113 patients comprising two groups of 55 cases and 58 controls. The first group comprised patients presenting with threatened miscarriage. The second group included females who had no complications. Spiral artery flow velocity measurements were performed using color Doppler (pulsatility index [PI], resistive index [RI], and systolic/diastolic ratio) in the first trimester (between 6 and 10 weeks of gestation). Patients were followed till 20 weeks and color Doppler was performed. Color Doppler in the first trimester and at 20 weeks was studied and their relation and association with adverse pregnancy outcome at 20 weeks were studied. Significant differences were noted in the spiral artery Doppler values in the two groups in first trimester and at 20 weeks. In particular, the RI and PI were higher in cases of women with threatened miscarriage in first trimester. Statistical significance of RI and PI was seen with adverse pregnancy with Doppler indices at 20 weeks. Doppler values of spiral artery may be used as a useful factor in assessing the prognosis in cases presenting with threatened miscarriage. Conclusion: Doppler flowmetry can be used, as a routine screening test to identify the high-risk women in early first trimester to offer effective prophylactic management strategies and for close monitoring and follow-up of these patients so as to have a successful pregnancy.