Abstract: Background: Pre-eclampsia (PE) is a major cause of maternal morbidity and mortality. Several studies have shown that a, generalized endothelial dysfunction is associated with these complications. Uterine artery Doppler studies both in the second and the first trimester can predict pregnancies at increased risk of the complications of impaired placentation. Uterine artery Doppler screening at 20 to 24 weeks’ gestation is superior to first trimester screening, and appears to fulfil the requirements for a worthwhile screening test. This study is about to see the usefulness of uterine artery Doppler in predicting pre-eclampsia and its complications.
Methods: A prospective observational study to see the usefulness of uterine artery Doppler in predicting pre-eclampsia and its complications was conducted on 100 high risk pregnancies. High risk Pregnant women between 16-28 weeks of gestational age with both normal and abnormal uterine artery Doppler are selected for the study. Detailed history, physical examination and necessary investigations will be undertaken. Uterine artery Doppler U/S was performed to evaluate uterine artery’s flow velocity waveforms. They were then used to calculate the presence of diastolic notch, resistance index (RI) and pulsatile index (PI). At each antenatal visit, the risk factors for PE such as BP, proteinuria, and signs and symptoms were noted. The patients are followed up with regular antenatal care including blood pressure measurement, urine examination for albumin, weight gain and other parameters as clinically indicated in each visit until termination of pregnancy.
Results: Age Distribution: Participants are under the age group of less than 20 years and more than 35 years, with a mean age of 25.08±5.
BMI: The mean Body mass index± SD of the high risk women was 25.415±4.
Blood Pressure: Blood pressure measurements showed a mean systolic blood pressure (SBP) of 153.76±15.383 mmHg and a mean diastolic blood pressure (DBP) of 101.98±11.528 mmHg.
Uterine artery Doppler parameters: Uterine artery Doppler parameters revealed that the right uterine artery had a mean resistive index (RI) of 0.7396±0.16114, a pulsatility index (PI) of 1.772±0.7117, and a systolic/diastolic (S/D) ratio of 4.1673±1.71155. The left uterine artery had a mean RI of 0.7618±0.15057, a PI of 1.8781±0.61973, and an S/D ratio of 4.4913±1.87162.
Gestational age at delivery: The gestational age at delivery indicated that 62% of participants delivered pre-term and 38% delivered at term, with a mean gestational age of 34.5±4.442 weeks.
Neonatal Outcomes: Neonatal outcomes showed that 27% of newborns were normal, 25% were dead, 46% had intrauterine growth restriction (IUGR), and 2% were stillborn.
Conclusion: uterine artery Doppler indices, specifically the resistive index (RI) and pulsatility index (PI), are significant predictors of preeclampsia. The findings indicated that elevated RI and PI values were strongly associated with the development of preeclampsia, highlighting the potential of these indices as early screening tools. In conclusion, the use of uterine artery Doppler indices can significantly enhance the early prediction and management of preeclampsia. This can facilitate timely interventions and potentially reduce the adverse outcomes associated with this condition.
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