scholarly journals Role of uterine and umbilical artery doppler assessment of the uteroplacental circulation in predicting pre-eclampsia: comparison between different doppler parameters

2017 ◽  
Vol 6 (10) ◽  
pp. 4314
Author(s):  
Vimla Dhakar ◽  
Sabiha Naz
Keyword(s):  
High Risk ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
High Sensitivity ◽  
High Risk Pregnancy ◽  
Trophoblast Invasion ◽  
Uterine Artery Doppler ◽  
Risk Pregnancy ◽  
Doppler Study ◽  
Umbilical Artery Doppler

Background: Hypertensive disorders are the common cause of maternal death which affecting nearly 5-10% of pregnancies all over the world. Pre-eclampsia develop from inadequate trophoblast invasion of the maternal spiral arteries and Doppler values permits non-invasive evaluation of uteroplacental circulation and is of great importance in the management of high risk pregnancies. The aim of the study was to assess the findings of Doppler data in predicting pre-eclampsia and comparison of the efficacy of uterine artery Doppler and umbilical artery Doppler.Methods: The study comprises of 100 women with high risk pregnancy attending antenatal clinic at Geetanjali Medical College and Hospital, Udaipur were subjected to uterine and umbilical artery Doppler Study. Women with high risk pregnancy between 26-32 weeks of gestation were studied with colour Doppler. This was a prospective study over a period of 1 year from 2015-2016.Results: The results of the study revealed that 5 out of 100 participants developed pre-eclampsia. Out of different parameters, notch is the best predictor of pre-eclampsia with high sensitivity and highest PPV for uterine artery Doppler and S/D ratio is considered to be best indicator for umbilical artery Doppler. Regarding efficacy, umbilical artery Doppler is more predictive than uterine Doppler.Conclusions: Doppler study can be used for the prediction of pre-eclampsia to reduce maternal morbidity and mortality.

scholarly journals Role of second trimester uterine artery doppler for the prediction of preeclampsia in high risk pregnancy

2019 ◽  
Vol 8 (3) ◽  
pp. 906
Author(s):  
Madhuri Thakur ◽  
Reeti Mehra
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Uterine Artery ◽  
High Risk Pregnancy ◽  
Second Trimester ◽  
Uterine Artery Doppler ◽  
Risk Pregnancy ◽  
Doppler Study ◽  
Doppler Indices

Background: The uterine artery Doppler has potentials for screening for complications of impaired placentation. The purpose of study was to assess the role of uterine artery color Doppler waveform analysis in second trimester for the prediction of preeclampsia in a high-risk pregnancy between 18-24 weeks of gestation.Methods: 100 women with moderate or high-risk factors for developing preeclampsia reporting to Obstetrics and Gynaecology department of Government Medical College and Hospital, Sector 32, Chandigarh were enrolled for present study. Transabdominal uterine artery doppler measurements was done at 18-24weeks of gestation in these patients. Doppler . The Doppler indices generated automatically from the machine , the Pulsatility Index (PI), Resistance Index (RI) , presence or absence of diastolic notch and S/D Ratio were recorded, and average was calculated.Results: Out of 100 patients there were 46 primigravidas with no additional risk factors, 22 pateints with two or more risk factors and there were no patients who had three or more risk factors in present study population. Preeclampsia is seen more commonly in primigravida and primigravida is considered as moderate risk factor for preeclampsia. It was found that an elevated second trimester uterine artery RI was significantly associated with developing preeclampsia later in pregnancy. The sensitivity and specificity of uterine artery Doppler velocimetry were found to be 84% and 55% respectively. Receiver operator characteristics (ROC) curves were created to demonstrate the prognostic value of RI and PI of uterine artery doppler indices at 18-24 weeks of gestation for the development preeclampsia. In addition, there were statistically significant positive correlations between mean RI of uterine artery doppler study and patients who developed preeclampsia. With a sensitivity of 84.21% it could identify 31% of the cases of preeclampsia at a false positive rate of 44.4%.Conclusions: Uterine artery doppler study can be used as a predictor of moderate strength for preeclampsia.

scholarly journals Doppler Velocimetry evaluation in high-risk pregnancy for prediction of Preeclampsia

2021 ◽  
Vol 12 (10) ◽  
pp. 135-141
Author(s):  
Rohini Singh ◽  
Sudipa Mondal ◽  
Manisha Bajaj ◽  
Debasmita Mandal
Keyword(s):  
High Risk ◽  
Uterine Artery ◽  
Umbilical Artery ◽  
Doppler Velocimetry ◽  
Third Trimester ◽  
Uterine Artery Doppler ◽  
Risk Pregnancy ◽  
Patients At Risk ◽  
Umbilical Artery Doppler ◽  
Doppler Indices

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.

scholarly journals Effects of Yoga on Utero-Fetal-Placental Circulation in High-Risk Pregnancy: A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Abbas Rakhshani ◽  
Raghuram Nagarathna ◽  
Rita Mhaskar ◽  
Arun Mhaskar ◽  
Annamma Thomas ◽  
...  
Keyword(s):  
High Risk ◽  
Standard Care ◽  
Uterine Artery ◽  
Controlled Trial ◽  
Resistance Index ◽  
High Risk Pregnancy ◽  
Trophoblast Invasion ◽  
Control Group ◽  
Risk Pregnancy ◽  
Yoga Group

Introduction. Impaired placentation and inadequate trophoblast invasion have been associated with the etiology of many pregnancy complications and have been correlated with the first trimester uterine artery resistance. Previous studies have shown the benefits of yoga in improving pregnancy outcomes and those of yogic visualization in revitalizing the human tissues.Methods. 59 high-risk pregnant women were randomized into yoga (n= 27) and control (n= 32) groups. The yoga group received standard care plus yoga sessions (1 hour/day, 3 times/week), from 12th to 28th week of gestation. The control group received standard care plus conventional antenatal exercises (walking). Measurements were assessed at 12th, 20th, and 28th weeks of gestation.Results. RM-ANOVA showed significantly higher values in the yoga group (28th week) for biparietal diameter (P= 0.001), head circumference (P= 0.002), femur length (P= 0.005), and estimated fetal weight (P= 0.019). The resistance index in the right uterine artery (P= 0.01), umbilical artery (P= 0.011), and fetal middle cerebral artery (P= 0.048) showed significantly lower impedance in the yoga group.Conclusion. The results of this first randomized study of yoga in high-risk pregnancy suggest that guided yogic practices and visualization can improve the intrauterine fetal growth and the utero-fetal-placental circulation.

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

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. 

scholarly journals A prospective study of role of doppler in pregnancy and the perinatal outcome

2020 ◽  
Vol 9 (2) ◽  
pp. 692
Author(s):  
Chaithra M. ◽  
Anitha G. S. ◽  
Sukanya Suresh ◽  
Savitha C.
Keyword(s):  
High Risk ◽  
Prospective Study ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Colour Doppler ◽  
Risk Pregnancy ◽  
Doppler Study ◽  
Flow Velocimetry ◽  
A Prospective Study

Background: The development of doppler ultrasonographic technology has provided an opportunity to obtain a qualitative and quantitative assessment of maternal and foetal circulation using a non-invasive method. It has been proved by many studies that doppler has a very important role in screening of high-risk pregnancies. Objective of this study was to evaluate the role of colour doppler study in normal and high-risk pregnancy in relation to perinatal outcome.Methods: A prospective study was done including 75 women with high risk pregnancy and 75 normal pregnant women during the period October 2018 to September 2019 in hospitals attached to Bangalore Medical College and Research Institute. Doppler examination was done after recording patients’ history, clinical examination and ultrasound. Results were analysed and conclusions were made.Results: Out of the 22 patients with PIH, 20 patients had abnormal umbilical artery S/D ratio and all 22 had abnormal MCA PI. Out of 12 patients with diabetes, 10 had abnormal umbilical artery S/D ratio. All the patients with IUGR had abnormal umbilical artery S/D ratio and abnormal MCA PI.Conclusions: Colour doppler flow velocimetry done repeatedly can predict adverse foetal events with a great degree of accuracy.

scholarly journals ROLE OF TRIPLE VESSEL DOPPLER ULTRASONOGRAPHY IN PREDICTION OF PERINATAL OUTCOME IN HIGH RISK PREGNANCY

2020 ◽  
pp. 19-23
Author(s):  
Manasa R ◽  
Priyanka Priyanka
Keyword(s):  
Birth Weight ◽  
High Risk ◽  
Perinatal Outcome ◽  
Pulsatility Index ◽  
Uterine Artery ◽  
Doppler Ultrasonography ◽  
Umbilical Artery ◽  
High Risk Pregnancy ◽  
Risk Pregnancy

Background and Objectives: To evaluate the role of Doppler ultrasonography in predicting the perinatal outcome in high-risk pregnancy and to establish its role in management of high-risk pregnancy. Materials and Methods: The present study is a prospective study of Doppler ultrasound evaluation of uterine artery, umbilical artery and middle cerebral artery in 100 high-risk pregnant women, performed between 28 and 34 weeks of gestation. Doppler index Pulsatility index (PI) for each above mentioned artery and cerebro-placental ratio (CPR) will be calculated. Doppler Pulsatility index for the corresponding gestational age were compared with the reference values. The results of the Doppler ultrasound and AFI will be used for analysis of mode of delivery and perinatal outcome in the form of birth weight, APGAR score, NICU admission, perinatal mortality. Results: Among newborns 46(46%) were admitted to NICU, 64(64%) of neonates had birth weight less than 2.5kg, there were 17 perinatal deaths. Of the 17 perinatal deaths, 2 cases had reverse end diastolic Flow (REDF) and 12 had absent end diastolic Flow (AEDF). Uterine artery PI was most sensitive(72.3%) than Umbilical artery PI(sensitivity 59.6%) and MCA PI(sensitivity 68.1%). Diagnostic accuracy of Cerebroplacental ratio (accuracy71%) was better than Umbilical artery PI (accuracy 65%) and MCA PI(accuracy 70%) in predicting adverse outcomes. Conclusion: Triple vessel colour Doppler sonography is very useful in high-risk pregnancy diagnosis and in predicting perinatal outcome.

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