Evaluation of Uterine Artery Doppler (Mean Pulsatility Index) at 11-14 Weeks of Gestation as Predictor of Hypertensive Disorders of Pregnancy: A Prospective Observational Study.

Abstract

The etiology and pathophysiology of hypertensive disorders of pregnancy remains enigmatic, and till date, no test can accurately predict it. Early screening may allow vigilant antenatal surveillance, timely delivery and thus substantially reduce maternal and perinatal morbidity and mortality. Our study aims to evaluate the predictive value of uterine artery mean pulsatility index (PI) at 11-14weeks and find a reference value for hypertensive disorders of pregnancy. A prospective study of 240 antenatal women using non-probability simple random sampling was carried out in a tertiary care center. Mean uterine artery PI was obtained at 11-14weeks of gestation. Pregnancies were followed till delivery and 7days postpartum. The major end point was development of hypertensive disorders of pregnancy. Maternal and neonatal outcomes were also assessed. The predictability of uterine artery mean pulsatility index (PI) at 11-14weeks for hypertensive disorders of pregnancy was significantly high with an odds ratio of 174.45 (95% CI 65.31-549.13; p < 0.0001), sensitivity (89.3%), specificity (95.8%), positive predictive value(90.5%) and negative predictive value (95.1%). Uterine artery mean PI at 11-14weeks of gestation is a cost-effective predictive test for hypertensive disorders of pregnancy, and the recommended reference value for Indian population of is 2.28.