Abstract
Background: The hypertensive pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality.Color Doppler ultrasound has been employed for fetal surveillance. Objective: To evaluate the role of Doppler study in the prediction of adverse pregnancy outcomes in hypertensive pregnant women at the third trimester of pregnancy. Patients and Methods: A clinical prospective follow up study conducted in Outpatient Ultrasound Clinic at Al-Imamein Kadhimein Medical City, Baghdad, Iraq from 1st July, 2018 till 31st of July 2019 included 50 pregnant women with hypertensive disorder of pregnancy at the third trimester. The fetal and neonatal outcome was reported poor when intrauterine fetal death occurs during follow-up of pregnant women or more than two of the reported neonatal complications were poor. Results: Means of the middle cerebral artery and umbilical artery-resistance and pulasatility indices ratio were significantly decreased among pregnant women with poor neonatal outcomes. Similarly, the umbilical artery end-diastolic flow and Ductus Venousu waveforms were Conclusion: The middle cerebral artery and umbilical artery indices of pregnant women with hypertensive disorders are good predictors for neonatal outcomes. Keywords: Hypertensive disorder, Middle cerebral artery, Umbilical artery, Ductus venosus
Highlights
Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE) and gestational hypertension (GHTN), were considered the most common pregnancy medical complications, affecting 6% - 8% of pregnant women [1], and they are one element of the deadly triad, along with infection and hemorrhage, which contributes significantly to maternal morbidity and mortality [2].Decreased uteroplacental blood flow, fetal hypoxemia, and intrauterine growth restriction (IUGR) are proposed hypotheses explaining the increased risks of fetal and infant death associated with pregnancy induced hypertension (PIH)
The results of umbilical artery (UA) Doppler is a reflection of the placenta status, whereas the results obtained from a middle cerebral artery (MCA) and aorta indicate the state of fetal circulation [10]
Doppler ultrasound is used in high-risk pregnancies, the cases complicated by fetal growth retardation, preeclampsia, or other maternal medical conditions [11]
Summary
Hypertensive disorders of pregnancy (HDP), including preeclampsia (PE) and gestational hypertension (GHTN), were considered the most common pregnancy medical complications, affecting 6% - 8% of pregnant women [1], and they are one element of the deadly triad, along with infection and hemorrhage, which contributes significantly to maternal morbidity and mortality [2]. Hypertensive Pregnancies complicated by preeclampsia show an increase in maternal and perinatal morbidity and mortality [4] and intrauterine growth restriction, as revealed by small for gestational age, involves a fair percent of newborn infants world widely, mostly in developing countries [5]. The results of umbilical artery (UA) Doppler is a reflection of the placenta status, whereas the results obtained from a middle cerebral artery (MCA) and aorta indicate the state of fetal circulation [10]. Doppler ultrasound is used in high-risk pregnancies, the cases complicated by fetal growth retardation, preeclampsia, or other maternal medical conditions [11]. Of adverse pregnancy outcomes in women third trimester of pregnancy. pregnant having hypertensive disorders at the Figure (1): Different flow velocity waveforms of the umbilical artery (A): Normal end-diastolic flow, (B): Reduced end-diastolic flow, (C): Absent end-diastolic flow (D): Reversed flow
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