INSULIN RESISTANCE AND UTERINE ARTERY DOPPLER AS PREDICTORS OF PREGNANCY INDUCED HYPERTENSION

Abstract

Background: In second trimester, pregnant women with Pregnancy Induced Hypertension (PIH) have different indices of uterine artery Doppler and different value of insulin resistance (IR) than normal pregnant women. Aim: This work aims to ascertain the role of uterine artery Doppler ultrasound and insulin resistance ratio in prediction of PIHPatients and methods: This cohort study(type of diagnostic test study) was done on 211 women during pregnancy in the period between 18-28wk, and the pregnant were followed until delivery. They were coming for antenatal care in the obstetric outpatient clinic at Al-Zahra University Hospital from January 2016 to December 2018.Results: In the current study, The mean age, Body Mass Index (BMI), gestational age, Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) among the studied group were 30.24(years), 25.08 (kg/m2), 22.40(wks),106.7(mmHg), 69.12(mmHg) , respectively, there were 9.5%of the studied group were hypertensive, 5.7%mild PIH and 3.4% severe PIH. There were highly significance difference statistically of uterine artery Doppler Indices between normotensive and PIH group and between IR and PIH. Cut value of IR as predictor for PIH patients is 1.2 with 70%sensetivity &70% specificity in the current study. Also, there were 42.8% of the severe hypertensive patients have diastolic notch, 28.5% have reversed diastolic flow and 28.5% have absent diastolic flow.Conclusion: IR was a good predictor for PIH. There was a highly statistically significant difference between IR and PIH group. Abnormal uterine artery Doppler had a high rate of detection of maternal and fetal complications. Uterine artery Doppler is a good diagnostic test for development of preeclampsia.Keywords: Pregnancy Induced Hypertension, uterine artery Doppler, insulin resistance.