Sonographic Association of Uterine Artery Pulsatility Index with Hypertension During Third Trimester of Pregnancy

Afrah Shahid ,Raham Bacha ,Maheen Munir ,Hira Iqbal ,Anmol Maqsood ,Umair Ahmad ,Muhammad Farooq ,Asad Ur Rehman ,Sana Shabeer

doi:10.7176/jhmn/72-07

Abstract

Background: Hypertension (HTN) in pregnancy is the second most basic reason for maternal death and cause obstetric complications in 5-10% of all pregnancies. HTN directly affects the blood flow of uterine artery. Doppler screening test is a valuable method to do safe and non-invasive detection and has high reliability in the detection of uterine artery blood flow characteristics. Objective: The purpose of the present study is to find association between predictive value of uterine artery pulsatility index in normal and hypertensive pregnancy during third trimester. Methods: A descriptive cross-sectional study was conducted with the sample size of 138 patients by selecting the convenient sampling from Ghurki Trust Teaching Hospital, Lahore. The pulsatility index of uterine artery of all the women with normal singleton pregnancy and hypertensive during third trimester of pregnancy were obtained using Doppler ultrasound. Data was analyzed with the help of Anova .The results were derived by mean, frequency and standard deviation . Results: The significance between groups was 0.002. The mean values of right and left uterine artery pulsatility index of 36 hypertensive patients were 1.40 and 1.41 and standard deviation 0.4 and 0.5 respectively whereas the mean values of right and left uterine artery pulsatility index of 102 normal patients were 0.739 and 0.77 and standard deviation 0.23 and 0.5 respectively Conclusion: Our study concluded that there was an association between uterine atery pulsatility index and hypertension during pregnancy. The uterine artery pulsatiltiy index has increased with hypertension in third trimester of pregnancy. Keywords: Hypertension, Pulsatility Index, Doppler Ultrasound DOI: 10.7176/JHMN/72-07 Publication date: March 31 st 2020

Highlights

Hypertension (HTN) in pregnancy is the second most basic reason for maternal death and cause obstetric complications in 5-10% of all pregnancies [1,2]
The velocity of blood flow in the uterine artery is measured by using Doppler ultrasound and expressed as pulsatility index (PI)
A study was conducted by Ashraf Jamal to determine the role of uterine artery pulsatility index at second and third trimester in predicting unfavorable pregnancy outcomes .They concluded that in those patients whose uterine artery PI was increseaed, the risks of adverse pregnancy outcome like pre-eclampsia was high 14.Another study was done by O

Summary

Introduction

Hypertension (HTN) in pregnancy is the second most basic reason for maternal death and cause obstetric complications in 5-10% of all pregnancies [1,2]. In HTN, the trophoblast invasion is abnormal, the placental perfusion is incomplete and utero-placental circulation remains in the state of high resistance 3. The first stage takes place between 8 and 10 weeks of gestation and begins with endovascular plugging of the spiral arteries by trophoblast cells. This is followed by trophoblast invasion and destruction of the musculoelastic media of the intradecidual segments of the spiral arteries. The second stage occurs between 14 and 16 weeks, and involves trophoblast invasion of the spiral artery segments in the inner third of the myometrium [9,10,11]. Doppler screening remarkably decreases the ratio of prenatal death and unnecessary medical interventions in high-risk pregnancies [12,13]

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