P02.10: Comparison of umbilical artery Doppler velocimetry with biophysical profile in monitoring high risk pregnancies

Background: The uterine and umbilical artery Doppler scan is a valuable tool for evaluation of utero-placental blood flow in pregnancy. They help in detecting uteroplacental insufficiency thus predicting preeclampsia and other effects of faulty placentation which increase the risk of adverse effects on both mother and fetus. Aims and Objective: This study aimed to evaluate and compare the uterine artery and umbilical artery Doppler indices in second and third trimester for prediction of preeclampsia in high-risk pregnancies. Materials and Methods: In this prospective observational study done over a years’ time, 50 high-risk pregnant mothers were recruited and the Doppler scans were done at 21-25 weeks and 31-35 weeks. The necessary clinical observations were recorded throughout the antenatal period and the data analysis was done. Results: Majority (56%) were in 20-29 years range with mean age of 24±6.1 years. Out of the 50 women, 21 had abnormal uterine artery Doppler and 12 had umbilical artery abnormality along with uterine derangement. Preeclampsia developed in 3 of them. The hypertensive disorders of pregnancy were diagnosed in 13 women, preeclampsia in 3, eclampsia in 1and other HDPs in 9. The persistence of notch in uterine artery was observed in 7 women, of these 2 developed PIH. Only one patient had uterine artery PI>1.45 at 24 weeks who subsequently developed preeclampsia. Among 4 patients of preeclampsia and eclampsia, 3 had 2nd trimester uterine and 3rd trimester umbilical Doppler abnormalities and only 1 had normal doppler indices. In 2nd trimester the sensitivity, specificity and PPV are higher for uterine artery PI as compared to umbilical artery PI. Hence, uterine artery doppler seems to be a better screening tool for early prediction of PIH. The third trimester umbilical artery PI with higher specificity (96%) and PPV (50%) can diagnose preeclampsia better. One patient had absent diastolic flow and she developed preeclampsia and IUGR. The combined uterine and umbilical artery doppler is a better screening modality as it has a higher sensitivity (75%) and NPV (99.26%). Conclusion: The uterine and umbilical artery Doppler velocimetry are potential tools for uteroplacental surveillance of high-risk pregnancies which can identify patients at risk and help in taking timely action to prevent complications.

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UMBILICAL ARTERY DOPPLER VELOCIMETRY AND ITS RELATION TO PERINATAL OUTCOME IN NORMAL AND HIGH-RISK PREGNANCIES

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2019/313 ◽

2019 ◽

Vol 8 (17) ◽

pp. 1408-1411

Author(s):

Kavya G. Venkatappa ◽

Sowbhagyalakshmi K. S. ◽

Shivaprasad Shivaprasad ◽

Kavana G. V ◽

Geetha H. N

Keyword(s):

High Risk ◽

Perinatal Outcome ◽

Umbilical Artery ◽

Doppler Velocimetry ◽

Umbilical Artery Doppler

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Relationship between the fetal biophysical profile score, umbilical artery Doppler velocimetry, and fetal blood acid-base status determined by cordocentesis

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(93)90441-k ◽

1993 ◽

Vol 169 (6) ◽

pp. 1586-1594 ◽

Cited By ~ 54

Author(s):

Bo Hyun Yoon ◽

Roberto Romero ◽

Cheng Rae Roh ◽

Seung Hyup Kim ◽

Joel W. Ager ◽

...

Keyword(s):

Umbilical Artery ◽

Doppler Velocimetry ◽

Fetal Blood ◽

Acid Base ◽

Biophysical Profile ◽

Profile Score ◽

Umbilical Artery Doppler ◽

Acid Base Status

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Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180184 ◽

2018 ◽

Vol 7 (2) ◽

pp. 628

Author(s):

Rashmi L. ◽

Ashish Bhattacharjee

Keyword(s):

High Risk ◽

Neonatal Intensive Care ◽

Umbilical Artery ◽

Fetal Outcome ◽

High Risk Pregnancy ◽

Doppler Velocimetry ◽

Average Birth Weight ◽

Risk Pregnancy ◽

Umbilical Artery Doppler ◽

Doppler Indices

Background: Umbilical artery Doppler indices in relation to fetal outcome in high risk pregnancy. The aim of this study was to study the umbilical artery Doppler velocimetry in predicting the fetal outcome in high risk pregnancy. This is a prospective study done over a period of 1 year in Silchar Medical College and Hospital from 1st September 2011 to 31st August 2012. 100 women with singleton pregnancy with high risk admitted in SMCH were subjected to umbilical artery Doppler along with morphology and biometry scan after fulfilling the inclusion and exclusion criteria.Methods: 100 women with high risk pregnancy were evaluated by umbilical artery velocimetry between 28 and 41 weeks of pregnancy. Outcome of pregnancy was recorded for the normal Doppler group (n = 79; 79%), the low-end diastolic flow group (n = 19; 19%) and the group with absent/reversed diastolic flow (n = 2; 2%).Results: Mothers with abnormal velocimetry had more number of caesarean sections than those with normal velocimetry. The diagnosis to delivery interval, gestational age at delivery and average birth weight were comparatively lower with higher incidence of admission to neonatal intensive care unit in foetuses with abnormal umbilical Doppler velocimetry. Sensitivity, specificity, positive and negative predictive values of Doppler for detecting abnormal fetal outcome were 43%, 83%, 33% and 88% respectively. Statistical analysis used: sensitivity, specificity and predictive values.Conclusions: Fetuses with normal flow velocimetry are at lower risk than those with abnormal velocimetry in terms of poor Apgar score and neonatal intensive care admission. The average birth weight of the neonates with abnormal Doppler studies was lower than that of neonates with normal velocimetry. Doppler velocimetry studies of umbilical artery can provide the obstetrician important information regarding fetal wellbeing to help him improve fetal outcome.

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Comparison of modified biophysical profile and Doppler ultrasound in prediction of perinatal outcome in high-risk pregnancies

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20202713 ◽

2020 ◽

Vol 9 (7) ◽

pp. 2808

Author(s):

Khushboo Malhotra ◽

Archana Kumari ◽

H. P. Anand

Keyword(s):

High Risk ◽

Pregnant Women ◽

Perinatal Outcome ◽

Umbilical Artery ◽

P Value ◽

Fisher Exact Test ◽

Perinatal Complications ◽

Singleton Pregnancy ◽

Biophysical Profile ◽

Umbilical Artery Doppler

Background: The objective of this present study was to compare MBPP and umbilical artery Doppler flow in high-risk pregnant women in prediction of perinatal outcome.Methods: A cohort study was done on 150 high-risk pregnant women over 16 months. Antenatal women with singleton pregnancy who delivered within 48 hours of performing MBPP and Doppler USG, with presence of ≥1 high-risk factor like pre-eclampsia/gestational HTN, BOH, post-dated pregnancy, FGR, GDM, maternal heart disease, anaemia, hypothyroidism and IHCP were included in the study. MBPP (NST and AFI) and umbilical artery Doppler was performed. Perinatal outcome was measured in terms of stillbirth/IUD, LBW, Apgar <7 at 5 minutes, admission to NICU, neonatal death within 48 hours of delivery, MSL and neonatal seizures within 24-48 hours. Quantitative variables were compared using independent t-test/Mann Whitney test. Qualitative variables were correlated using Chi square test/Fisher exact test. Sensitivity, specificity, NPV, PPV were calculated and p-value <0.05 was considered statistically significant. Data analysis was done using social sciences (SPSS) licensed version 21.0.Results: Majority belonged to the age group 21-25 years and were between 37-40 weeks of gestation. It was found that highest perinatal complications occurred in those with both abnormal MBPP and Doppler followed by those with only abnormal MBPP (p-value<0.0001).Conclusions: MBPP is a better predictor of perinatal outcome compared to umbilical artery Doppler USG in high-risk pregnant women. MBPP should be done in all high-risk pregnancies even if Doppler is normal. Both the tests must be performed in all high-risk pregnancies to improve perinatal outcome.

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