Title: Study of Color Doppler of Uterine Artery, Umbilical Artery, Middle Cerebral Artery in PIH Patients on Antihypertensive Therapy
Authors: Dr Yashodhara Gaur, Dr Rashmi Jacob Kujur, Dr Hemlata Parashar
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.138
Abstract
Background: Hypertensive disorders remain one of the leading causes of both maternal and perinatal mortality.
Aims and Objective: To study the effect of antihypertensive drugs on hemodynamics of mother and fetus, uterine artery, umbilical artery, middle cerebral artery via flow velocity time wave and to compare Doppler study with control group.
Materials and Methods: A randomized prospective comparative study on 35 PIH patients was done in the Obstetrics and Gynecology Department, Kamla Raja Hospital Gwalior attending OPD. Two groups were formed as study (n=18, on antihypertensive drugs) and control (n=17, not on antihypertensive drugs). A detailed history along with laboratory investigations along with Color Doppler for both the groups was performed.
Results: Most of the patients belong to <25 years age group, were direct cases and belonged to urban area in both the Control and Study groups (58.82% vs. 61.11%, 76.47%vs. 88.88%, 94.11% vs. 88.88% respectively). Unbooked (88.23%) patients were more among control whereas booked (61.11%) patients were more among study group. Most of the patients were primigravida in both the groups. Maximum patients among Control (94.11%) and Study groups (83.33%) were of 32-37 weeks of gestation. Significant difference was recorded among Study group before (161.11/103.88 mmHg) and after (147.22/97.77 mmHg) antihypertensive treatment (P<0.001)for systolic and diastolic blood pressure respectively. Colour Doppler revealed that umbilical artery (1.13 vs. 1.23), middle cerebral artery (1.35 vs. 1.41) pulsatility index (PI) as insignificantly increased after treatment whereas PI of right uterine artery (0.91 vs. 0.89) and left uterine artery (0.84 vs. 0.82) insignificantly decreased before and after treatment respectively.
Conclusion: Antihypertensive drugs affect maternal hemodynamic and to certain extent fetal hemodynamic as evident by middle cerebral artery colour doppler indices but it was not significant.
Keywords: Antihypertensive, colour Doppler, middle cerebral artery, hemodynamic.
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Dr Yashodhara Gaur
Professor - Dept of Obstetrics and Gynaecology
G.R. Medical College, Gwalior