“TO ASSESS FETO-MATERNAL CIRCULATION BY DOPPLER STUDY IN WOMEN WITH THIRD TRIMESTER AND ITS CO RELATION WITH FETO-MATERNAL OUTCOMES.”

Abstract

INTRODUCTION : Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity throughout the world, accounting for 24% of all maternal deaths in India. 1,2 In developed countries, it accounts for 7-10% of perinatal mortality and 20% in developing countries. Early detection of preeclampsia may allow for vigilant antenatal surveillance and timely foetal delivery to avoid serious complications. The aim of the study was to determine and compare the diagnostic performance of Doppler sonography of fetal middle cerebral artery (MCA) and umbilical artery (UA) in prediction of adverse perinatal outcome in suspected intrauterine growth retardation (IUGR) and severe PE. METHODOLOGY: 100 pre-eclampsia patients were taken in study at Sir T. General Hospital, Bhavnagar from January 2021 to July 2022. The various measures of central tendencies and graphical representations were used to analyse the data. RESULTS: Majority of patients were in the age group of 26-30 years. Maximum incidence was seen with primigravida (65%).Out of all patients maximum patients delivered normally (67%). Patients delivered low birth weight babies were around 38%. Umbilical Artery Doppler parameters such as abnormal S/D ratio,Elevated Resistivity index, and elevated Pulsatility Index were found as (78.72%), (80.85%) and (87.23%) in Adverse Outcome event which is statistically signicant compared to Good outcome(p<0.0001). Middle cerebral artery Doppler parameters such as abnormal S/D ratio, Elevated Resistivity index, and elevated Pulsatility Index are found as (25.53%),(76.59%) and (72.34%) in Adverse Outcome event which is statistically signicant compared to Good outcome(p<0.0001). In addition, Cerebro Placental Ratio have found signicantly high abnormality (89.36%) of neonates in adverse group. CONCLUSION: The Doppler technology is helpful in repetitive noninvasive haemodynamic monitoring of pregnancy. In an obstetric patient population with a high prevalence of complications like preeclampsia, the Doppler indices from the fetal circulation can reliably predict adverse perinatal outcomes. Thus the appropriate timing of delivery is to be made before these changes occur. However, the Doppler study of multiple vessels helps predict adverse outcomes , manage high-risk pregnancies complicated by preeclampsia