Role of color doppler ultrasound to evaluate preeclampsia

Abstract

Introduction Worldwide preeclampsia (PE) is the leading cause of maternal death and affects 5 to 10% of pregnant women. PE is characterized by elevated blood pressure and proteinuria. Doppler Ultrasound (US) evaluation has been considered a useful method for prediction of PE. Uterine artery is the most studied vessel in the Doppler evaluation in PE, because it represents the maternal vascular condition, through the presence of early diastolic notch and resistance index(RI). Objective The aims and objective of this study was to evaluate the uterine, umbilical and the middle cerebral arteries using Doppler US parameters [resistive index (RI),),Pre-diastolic notch (N), pulsatility index (PI) and their combinations] in pregnant women to evaluation of hemodynamic repercussion caused by the established PE. Methods and Patients A total of 102 pregnant women (65 PE women and 37 normotensive women) were recruited in a cases and controls study. The cases group consisted by diagnosed PE women according to the guidelines of the International Society for the Study of Hypertension in Pregnancy. Blood velocity waveforms from uterine, umbilical and middle cerebral arteries, in pregnancies from 24 to 37 weeks of gestation were recorded by trans-abdominal examination with a 3.5 MHz convex transducer. Results Out of 102 pregnant women (65 PE women and 37 normotensive women) were recruited in a cases and controls study. Cases group shows 38 mild and 27 severe PE. 56.9% shows PE before 34 GW and the remaining 43.1% shows disease at 34–37 GW. Abnormal Doppler US profile (Presences of Notch and RI of Uterine artery) showed a positive association with PE [odds ratio (OR) = 2.93, 95% confidence interval (CI) = 1.2 - 7.3, P = 0.021)] and a specificity and positive predictive value of 89.2% and 88.6% respectively. Other parameters like RI and PI of umbilical artery, as well as the PI of middle cerebral artery, showed differences between groups (P values Conclusion General Doppler US result, as well as RI and Notch from uterine artery, RI and PI from umbilical artery and PI middle cerebral arteries in their individual form may be considered as tools to determine hemodynamic repercussion caused by preeclampsia (PE).