VALUE OF 3-D USS OF PLACENTAL VOLUME, UTERINE AND UMBILICAL ARTERY DOPPLER IN PREDICTION OF PRE-ECLAMPSIA

Abstract

Background: Preeclampsia is a multisystem disorder of pregnancy defined by the combination of new-onset hypertension and proteinuria that contribute substantially to perinatal morbidity and mortality worldwide. Ultrasound can currently be used in the detection of adverse pregnancy outcome for example in Pre-eclampsia where Doppler indices and spectral wave forms are used. Objective: To use Doppler ultrasound for evaluation on of placental volume changes using 3-D USS, as well as abnormalities in uterine and umbilical artery Doppler indices in prediction of pre-eclampsia. Patients and Methods: This study was conducted in Department of Obstetrics and Gynecology of Al-Hussein Hospital, Al-Azhar University during the periods May 2016 till April 2017. This was a prospective observational study that carried on two hundred pregnant women enrolled into two equal groups. Group A consisted of 50 primipara and 50 multipara women with known risk factor to develop pre-eclampsia like previous history or medical disorder such as chronic hypertension and Group B consisted of 50 primipara and 50 multipara women without any risk factor to develop pre-eclampsia. Results: There was no statistically significant difference between both groups as regard to umbilical artery pulsatility index (PI), while umbilical artery resistance index (RI) and abnormality have higher statistically significant values in group A. There was a statistically significant difference between both groups as regards uterine artery PI, RI, abnormality and persistent notch (p value= 0.025, 0.037, 0.001 and 0.001 respectively). There was statistically significant difference between PC and MG as regards to uterine artery abnormality and persistent notch. There was no statistically significant difference between both groups as regards to placental volume. ROC results revealed that umbilical artery RI, uterine RI, and placental volume cutoff values were higher than 0.67, 0.56, and 43 and the area under the ROC curve was equal to 0.672, 0.851 and 0.527. The sensitivity values of umbilical artery RI, uterine RI, and placental volume were 83.0, 86.5 and 79.2 respectively and the specificity values were 73.3, 60.0 and 62.5 respectively. Conclusion: Three-dimensional Doppler ultrasound results, as well as resistance index from umbilical artery and uterine artery pulsatility index, resistance index, abnormality and persistent notch, could be considered as tools to determine hemodynamic repercussion caused by preeclampsia.