Prediction of preeclampsia and adverse pregnancy outcome on the basis of uterine artery doppler

Abstract

Background: Hypertensive disorders complicating pregnancy are common. Preeclampsia and eclampsia are major causes of maternal morbidity and mortality, particularly in developing countries. With prompt recognition of symptoms and early diagnosis of preeclampsia can lead to improved maternal and neonatal outcome. Numerous tests have been proposed for the prediction of preeclampsia, their results have been inconsistent. We focused to investigate the uterine artery by conducting Doppler ultrasound study in predicting the preeclampsia in women with a high-risk pregnancy. Methods: This prospective cross-sectional observational study was conducted on 195 pregnant women referred to Acharya Vinoba Bhave Rural Hospital, Wardha (India). Uterine artery Doppler was conducted on all women with raised blood pressure referred to the radiology department. The patients were followed up and outcomes such as eclampsia, chronic hypertension, death, neonatal intensive care unit (NICU) admission, low birth weight, and preterm labor association with preeclampsia were measured. Results: The mean age of pregnant women was 26.47 ± 4.96 years old. Preeclampsia was seen in 68 (34.9%) of the women. In the study, maternal outcome such as eclampsia and maternal high blood pressure (HTN) was significantly associated with preeclampsia. Similarly, neonatal outcomes such as low birth weight, NICU admission, and intrauterine growth restriction were significantly associated with preeclampsia. Pulsatility Index (PI) at >1.2 had the highest sensitivity of 64.71%, specificity of 71.65%, positive predictive value of 55%, and negative predictive value of 79.1% to predict preeclampsia than any other Doppler indices. Conclusion: The findings of this study suggest that PI at >1.2 had better validity in predicting preeclampsia compared to resistive index (RI) and Standard deviation.