Title: Role of First and Second Trimester Uterine Artery Doppler in Prediction of Pre-Eclampsia
Authors: Dr L.V.V. Prasad MD (RD), Dr Y. Trinadh, Dr Krishna Reddy
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.137
Abstract
Background: Pre-eclampsia is the most important reason for maternal and fetal mortality. It affects 2-5% of pregnancies and is principally a disease of first term pregnancy1. Pre-eclampsia is due to reduced organ perfusion due to vasospasm and endothelial damage. Almost all the morbidity being due to multisystemic manifestations in many organs including brain, liver, kidney and placenta. IUGR is a complication of pre-eclampsia and is due to failure of normal placental invasion and development.
Materials and Methods: This is a prospective study done over a period 15 months at radiology department, Andhra medical college from April 2017 to July 2018. 100 women with singleton pregnancy attending Victoria General Hospital OPD referred to the radiology department, KGH is subjected to uterine artery Doppler along with morphology and biometry scan to study the role of uterine artery doppler in predicting pre-eclampsia.
Results: The highest incidence is noted in 21-25 years age group followed by below 20 years age group. It is more common in primigravida. 7 pregnant women developed proteinuria of which all developed preeclampsia. 10 babies developed preeclampsia of which 7 are preterm.
Conclusion: Uterine artery Doppler can be used to predict pre-eclampsia in normal people who are not having risk factors. The diastolic notch in second-trimester has the highest specificity compared to other parameters. First-trimester doppler alone has a good predictive value in predicting pre-eclampsia. Combination of first and second-trimester uterine artery Doppler is the best indicator of prediction of Pre-eclampsia. Women with normal impedance to flow in the uterine arteries constitute a group that have a low-risk (negative predictive value of 96%) of developing obstetric complications related to uteroplacental insufficiency and fetoplacental insufficiency. Uterine artery Doppler can be included in hospitals with facilities and infrastructure to identify a group of patients at risk of developing Pre-eclampsia.
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