Evaluation of the predictive value of uterine artery doppler in second trimester of pregnancy as a screening tool for preeclampsia

Abstract

This study was carried out to determine the validity and reliability of Uterine Artery (UtA) Doppler imaging as a screening tool for predicting preeclampsia among pregnant women attending a tertiary care hospital of the Armed Forces in second trimester.Our study was a prospective diagnostic study carried out in 680 pregnant women (age group of 19 to 30 years) in second trimester. Maternal BP was recorded using automated BP apparatus on three occasions (15 minutes apart) in supine posture. This was followed by uterine artery Doppler with measurement of Resistivity index (RI) and Pulsatility index (PI). Patients were followed up every month till 12 weeks post-partum. Statistical analysis was done using SPSS version 21. The mean uterine artery PI was 1.21±0.296 and the mean uterine artery RI value was observed to be 0.58±0.18. The incidence of preeclampsia among the study participants was observed to be 9.9%. The mean uterine artery PI and RI among patient with preeclampsia was found to be significantly higher than those without preeclampsia (p value <0.001). The uterine artery PI values of ≥1.3 when defined as a diagnostic cut off, the sensitivity and specificity was found to be 79.1% and 70.8% respectively. The accuracy was observed to be 71.62%. The uterine artery RI values of ≥0.7 when defined as a diagnostic cut off, the sensitivity and specificity was found to be 44.78% and 89.72% respectively. The accuracy was observed to be 85.29%. Uterine artery PI parameter is found to have better sensitivity than RI in predicting preeclampsia. Consideration of both PI and RI parameters for prediction of preeclampsia significantly increased the specificity of Uterine Artery Doppler Imaging. Uterine Artery Doppler is a useful tool in predicting the risk of preeclampsia among women in second trimester of pregnancy.